Sooner rather than later.

That’s the general advice given by medical professionals to women for having their heart health checked.

Plaque buildup in the arteries and other problems that lead to heart disease can begin manifesting when people are in their teens and early 20s.

However, most women in the United States don’t think they should begin getting heart screenings until much later.

A national online survey commissioned by Orlando Health polled 2,054 U.S. adults, including 1,062 women. A majority of women — 60 percent — believe that heart screenings aren’t recommended until people are in their 30s.

Just 8 percent of women thought heart screenings should start in their 20s.

On average, women think a seemingly healthy person should begin getting heart screenings at the age of 41.

A cardiologist who spoke to Healthline said awareness of heart disease has come a long way, but there are still significant gaps in education and perception.

Read more: Women slower to be diagnosed and treated for heart disease »

Not just a problem for men

Cardiovascular diseases are the number one cause of death worldwide.

They’re the number one killer of women in the United States.

Dr. Maria Carolina Demori, a cardiologist who leads the Women’s Cardiac Center at Orlando Health Heart Institute, says women traditionally haven’t been aware of the risks of heart disease.

“We used to think that heart disease was more of a men’s problem,” she told Healthline. “However, women were dying of heart disease more than men for many years — for decades. Now, women are dying less of heart disease than men, but it’s still the number one killer of women. There’s a significant lack of awareness of heart disease in women, and only about 50 percent of women know that the number one killer of women is heart disease.”

Dr. Maria Carolina Demori with a patient. (Photo courtesy of Orlando Health)

Demori says that men are more likely than women to recognize heart attack symptoms such as chest pains and shortness of breath.

“It’s better now, but in the past, doctors would often diagnose these symptoms in women as anxiety or indigestion, rather than something more serious,” she said.

“One fact for sure is that many cardiovascular trials, in the past, were for men. For some reason, more men got enrolled in these trials than women,” says Demori. “Women, I think, sometimes seek medical care less often because they’re busy. This is harmful because we know that women do poorly when they have a heart attack. They’re more likely than men to die after experiencing a heart attack.”

Another possible reason for the perception of cardiovascular disease as a problem for men is the different physiology between the sexes.

“Women sometimes don’t have the significant obstructions in the coronary artery that would lead to a positive stress test,” says Demori. “In men, there are more obstructions, so a stress test is more likely to turn up positive. Now, we have better techniques, so it’s easier to determine when arteries are not dilating and working properly.”

Demori says there’s reason for optimism as awareness increases.

“I think now, women are more aware of the symptoms of heart disease and, therefore, they’re now looking for help, while in the past they may not have,” she said. “Many of the risk factors for heart disease were tailored more toward men than women in the past, while now they’re tailored for women as well.

Read more: Men’s and women’s hearts age differently »

Early education crucial

Despite advancements in diagnosing cardiovascular diseases, the survey indicates that most women don’t think screening is necessary for an otherwise healthy person until later in life.

The American Heart Association recommends men and women begin regular checkups for blood pressure, cholesterol, and body mass index when they’re 20.

Demori agrees, saying people should begin seeing their doctor for heart screenings right after their teen years, pointing out that undiagnosed heart problems only get worse with time.

“I think education at a very early age is important,” she says. “I don’t think we should wait until people are in their 20s, 30s, or 40s to educate people. Education can start very early, at school. We can teach kids that they can prevent and reduce their risk of heart disease by helping them understand that they can start developing that plaque in their arteries as early as their teen years.”

“It is something that can progress and get really bad, depending on risk factors,” Demori added. “So I think educating kids at a young age, telling them that this is something they can prevent, would be a big step in the right direction.”

Read more: The heart attack you never knew you had »