Heart disease kills more women than anything else. In 2023, it was responsible for 304,970 female deaths in the United States, roughly 1 in every 5. Cancer follows closely behind, claiming 286,543 women’s lives in 2021. Together, these two conditions account for more than a third of all female deaths, and the risks, symptoms, and patterns behind each one look different for women than many people assume.
The Top 10 Causes of Death for Women
Based on 2021 data from the National Vital Statistics System, the leading causes of death among U.S. women break down like this:
- Heart disease: 310,661 deaths (19.1%)
- Cancer: 286,543 deaths (17.6%)
- COVID-19: 180,283 deaths (11.1%)
- Stroke: 92,038 deaths (5.7%)
- Alzheimer’s disease: 82,424 deaths (5.1%)
- Accidents: 75,333 deaths (4.6%)
- Chronic lower respiratory diseases: 74,814 deaths (4.6%)
- Diabetes: 44,666 deaths (2.7%)
- Kidney disease: 25,769 deaths (1.6%)
- High blood pressure: 22,730 deaths (1.4%)
These ten causes together represented about 1.63 million deaths, or 46.9% of all reported female deaths that year. The remaining deaths spread across dozens of other conditions.
Heart Disease Looks Different in Women
Heart disease has held the number one spot for decades, yet many women don’t recognize it as their greatest threat. Part of the problem is that heart attacks in women often don’t look the way people expect. The classic image of sudden, crushing chest pain is far more typical in men. In a study published in Circulation, only 30% of women reported chest discomfort before their heart attack.
Instead, the most common warning signs women experienced in the weeks before a heart attack were unusual fatigue (70%), sleep disturbance (48%), shortness of breath (42%), indigestion (39%), and anxiety (35%). These symptoms are vague enough that women, and sometimes their doctors, attribute them to stress, aging, or other conditions. That mismatch between expected and actual symptoms is a major reason women have more unrecognized heart attacks than men and are more likely to be misdiagnosed in emergency departments.
Which Cancers Kill Women the Most
Cancer is the second leading cause of death overall, but not all cancers carry equal risk. The deadliest cancer for women is lung cancer, expected to kill an estimated 60,540 women in 2025. Breast cancer, despite being more commonly diagnosed, ranks second with an estimated 42,170 deaths. Colorectal cancer follows at 24,000 deaths.
The good news is that death rates for all three are declining. Lung cancer mortality among women has been dropping at about 3% per year, breast cancer at 1.5% per year, and colorectal cancer at about 0.9% per year. These declines reflect better screening, earlier detection, and improved treatments. Still, lung and breast cancers combined account for nearly half of all female cancer deaths, making them by far the most important cancers for women to be aware of.
Stroke Hits Women Harder
Stroke is the fourth leading killer of women, taking 92,038 lives in 2021. Women face several risk factors that men simply don’t have. High blood pressure during pregnancy, certain hormonal birth control methods (particularly for women who also smoke), and higher rates of depression all increase stroke risk specifically in women. In the U.S., 1 in 5 women between ages 55 and 75 will have a stroke.
Alzheimer’s Disease Takes a Disproportionate Toll
Alzheimer’s disease officially ranked fifth among female causes of death in 2021, with 82,424 recorded deaths. But that number almost certainly understates the real toll. A 2023 analysis estimated that 271,700 female deaths that year were actually attributable to Alzheimer’s dementia, putting it on par with cancer as a leading killer of women. The gap between the official count and the estimate exists because Alzheimer’s contributes to death in ways that get recorded under other causes, like pneumonia or heart failure, on death certificates.
Women make up roughly 60% of all Alzheimer’s deaths. This isn’t simply because women live longer. Researchers continue to investigate biological factors, including hormonal changes after menopause, that may make women’s brains more vulnerable to the disease.
Chronic Lung Disease and the Smoking Legacy
Chronic lower respiratory diseases, primarily chronic obstructive pulmonary disease (COPD), killed 74,814 women in 2021. Globally, 1.6 million women died from COPD that same year. While overall mortality rates for COPD in women have dropped about 37% worldwide since 1990, the trend in the U.S. has gone the opposite direction. COPD death rates among women in high-income North America rose by 49.3% over that same period, a pattern largely tied to the delayed wave of smoking-related disease in women who took up cigarettes in the mid-20th century.
This makes the U.S. an outlier. In most of the world, improvements in air quality, reduced cooking smoke exposure, and declining tobacco use have pushed female COPD deaths downward. Countries in Eastern Europe saw declines as steep as 75%.
Diabetes and Kidney Disease
Diabetes ranked eighth, officially causing 44,666 female deaths in 2021. Like Alzheimer’s, diabetes contributes to far more deaths than it directly receives credit for, since it accelerates heart disease, kidney failure, and stroke. Kidney disease itself ranked ninth at 25,769 deaths, and the two conditions are closely linked: diabetes is the leading cause of kidney failure.
Diabetes is the seventh leading cause of death for all Americans combined, with 95,190 total deaths recorded in 2023. Women with diabetes face a particularly elevated risk of heart disease compared to women without it, narrowing the cardiovascular advantage that women in the general population typically have over men.
What Younger Women Should Know
The rankings above reflect all ages combined, and they’re heavily weighted toward older women because that’s where most deaths occur. For younger women, the picture shifts dramatically. Accidents, including drug overdoses and car crashes, are the leading cause of death for women under 45. Cancer also ranks high in this age group, with breast and cervical cancers affecting women at younger ages than most other cancers. Heart disease, while rarer in younger women, does occur and is more likely to be missed precisely because doctors aren’t looking for it in a 35-year-old patient.
Maternal mortality, while not appearing in the overall top 10, remains a significant concern for women of reproductive age in the U.S., which has the highest maternal death rate among wealthy nations. Pregnancy-related complications disproportionately affect Black women, who die at roughly three times the rate of white women during or shortly after pregnancy.