Background: Though heart disease is the leading killer of women in the United States, many of them are unaware of their individual risks. Studies have shown that awareness of cardiovascular disease risk correlates with positive behavior changes, including increased physical activity and weight loss, leading to a heart-healthy lifestyle. The purpose of this study was to assess women’s awareness of their heart disease risk and barriers to starting heart healthy behaviors, such as improved diet and exercise. Methods: The Change of Heart (COH) Program at the University of Kansas Hospital conducted a self-reported assessment on women’s perceived barriers to leading heart-healthy lifestyle. Participants (N = 157) of this study were recruited from Mid-America Cardiology and their age ranged from 29 to 78 years (M = 53 years). Additionally, participants had an average education level of college and above and the median income was greater than $60,000. The assessment included questions regarding family and other care giving responsibilities, personal perception of heart disease risk, availability of indoor exercise facilities, and community access to fresh fruit and vegetables. Results: The three most common personal barriers amongst this population were family and other care giving obligations (87%), not perceiving oneself to be at risk for heart disease (63%), and feeling too stressed to accomplish one’s tasks (51%). Additionally, the three most common community barriers were a lack of nutritional information posted on restaurant menus (32%), not having access to indoor exercising facilities (17%), and not having access to support groups, such as weight management, smoking cessation (13%). When participants were asked what their intentions to make lifestyle changes to lower heart disease risk, 66% answered either an 8 or 9 on a scale of 0 (no intention) to 10 (most intention); however, 21% of women did not or occasionally did not believe they had control over their health conditions. The majority of participants had access to fresh fruits and vegetables (66%), to smoke free restaurants and public facilities (75%), and to safe, outside, public exercises areas (61%). Conclusion: In this well-educated cohort of women, the most common barrier to leading a heart-healthy lifestyle was lack of time due to family obligations. Most women were aware that women in general needed to make healthy changes in their lives, but they did not personalize their risk. This study suggests that women, even with available resources, need to be assessed, reminded, and encouraged to develop behavioral skills and strategies (e.g. time management) to incorporate heart healthy behaviors into their lifestyle.