Mammograms Could Screen Women for Heart Disease Risk, Research Shows Research suggests mammograms could soon be used to detect cardiovascular disease risk in women, as AI measures breast arterial calcification to flag heart attack and stroke risk earlier. Mammograms could soon be used to screen women for cardiovascular disease risk, according to recent research. The scans, already offered every three years to women aged 50 to 71 in the UK, might reveal dangers far beyond breast cancer. Cardiovascular disease kills around seven times more women in the UK than breast cancer, claiming over 80,000 women's lives each year. Why Women's Heart Risk Is MissedWomen with cardiovascular disease are often understudied, under-recognised, underdiagnosed, and undertreated, according to a landmark study in The Lancet in 2021. This problem is visible daily in hospital emergency departments.A woman in her late-60s recently arrived with a heart attack and needed urgent surgery to open a blocked artery. She had felt the same pain two days earlier, but an A&E doctor dismissed it as muscle strain from gardening because it did not match the classic pattern of crushing chest pain spreading down the left arm.That pain was almost certainly unstable angina, a warning that an artery supplying her heart was becoming critically narrowed. If recognised, she could have been admitted and had a stent inserted to open the artery before it became blocked. The heart attack could have been prevented, along with potential long-term damage.Doctors are not as good as they should be at recognising heart disease in women or understanding their risk. A longstanding bias in medical research and education, based predominantly on men, is partly to blame. The classic heart attack with crushing chest pain spreading to the arm or jaw is the male pattern, but a heart attack can look different in women.Hormonal factors play a part, and women are more likely to have problems affecting the smaller blood vessels of the heart rather than just one large artery. This may explain why women can develop broader symptoms, including breathlessness, nausea, fatigue, or pain in the back, neck, or jaw.A study by the University of Leeds in 2016 analysed more than half a million heart attack patients. It found that women were around 50 per cent more likely to have been given the wrong diagnosis when they arrived in hospital. Those initially misdiagnosed had a 70 per cent higher risk of dying within 30 days than those whose heart attack was detected from the start.Female-Specific Risk Factors OverlookedThere is also a bias with risk factors. Smoking, high blood pressure, diabetes, and high cholesterol are well known, but important female-specific risks for cardiovascular disease receive less attention than they deserve.These include pre-eclampsia (high blood pressure in pregnancy), gestational diabetes (also during pregnancy), premature menopause, and polyendocrine metabolic ovarian syndrome (previously known as polycystic ovary syndrome). Yet these are still not routinely part of the conversation when assessing a woman's heart risk.We need to get much better at finding cardiovascular risk in women long before they arrive in A&E. The answer may lie in the mammograms women are already having every three years between the ages of 50 and 71.AI Measures Breast Arterial CalcificationWhen blood vessels become damaged, calcium can start to build up in their walls. Radiologists have known for years that calcium can also sometimes build up in the breast arteries, seen on a mammogram. This is not the same as the calcium in fatty plaques inside the coronary arteries, as it builds up in a different part of the artery wall.However, women with more breast arterial calcification are more likely to go on to have a heart attack or stroke. That is why some radiologists flag this up to the doctor. Compared with women with no calcification, those with mild calcification had around a 30 per cent higher risk of a major cardiovascular event such as a heart attack or stroke.Rather than relying on an individual radiologist, research now shows that artificial intelligence can measure the calcium automatically. In a study published in the European Heart Journal, researchers used AI software trained to recognise arterial calcification in mammograms taken for cancer checks from more than 123,500 women in the US.The AI classified the women as having no, mild, moderate, or severe calcification in the breast. The researchers then compared this with the women's medical records over seven years. The results were striking, with mild calcification linked to around a 30 per cent higher risk of a major cardiovascular event such as a heart attack or stroke.This approach could transform how women's heart risk is detected, using scans they already receive. Earlier identification would allow preventive treatment and could save thousands of lives each year, addressing the persistent gap in women's cardiovascular care.