Cardiovascular disease (CVD) is a leading cause of mortality among women in Spain, yet historically, research and clinical focus have primarily targeted men. To intensify prevention measures, it is crucial to investigate the main risk factors in women with CVD and the variables that are most relevant to disease outcomes. We investigate postmenopausal women with CVD, focusing on lifestyle habits, risk factors, and their impact on long-term outcomes. Data from the 2011 Spanish National Health Survey and the national death register were utilized. These data include a complex 3-stage stratified sampling design to achieve a representative sample of all residents of Spain over the age of 15 years. Sociodemographic, lifestyle, health status, self-perceived health, health service utilization, and treatment data were analyzed. Among 974 eligible participants, a high prevalence of risk factors was observed. The 10-year cumulative incidence of cardiovascular death in this population is high (22.5%). Among the predictors of death, as well as age and diabetes, there are modifiable factors such as lack of leisure-time physical activity and low consumption of vegetables. Findings underscore the significance of lifestyle interventions in secondary prevention among postmenopausal women with CVD. By addressing modifiable risk factors, considerable reductions in CVD mortality risk and improvements in life expectancy can be achieved. The creation of a specific risk scale for 10-year cardiovascular death in this population shows the considerable value of information that can be obtained through history-taking, without the need for diagnostic testing.