Healthy Heart Options for Women -
Preventing Heart Disease How to Reduce Your Risk

Who Gets Heart Disease?

Heart disease is a woman's concern—every woman's concern. To understand why, simply look at the statistics.

• The lifetime risk of developing coronary heart disease is one in three for women age 40 and younger. At age 70, one out of every four women will develop it.
• Women are more likely than men to die of a first heart attack.
• Each year, about 370,000 women die of heart disease, making it the number-one killer of American women.

While these statistics are alarming by themselves, what's even more disturbing is that so many women are unaware of them. Many women believe that breast cancer is the greatest threat to their health. However, your lifetime risk of heart disease is far greater than your risk of breast cancer.

This site is designed to make you aware of heart disease and its impact on your health and life. It tells you why and when you should be concerned about your own heart health and what you can do to prevent heart disease. After all, the steps you take to protect your heart can help you enjoy a longer, healthier, more active life.

What is a Risk Factor?

Risk factors are traits or habits that make you more likely to develop a disease. Some women have more risk factors for heart disease than others do. Some of these can't be changed—a family history of heart-related problems, for example. But others can be changed.

The three major risk factors that you can do something about are cigarette smoking, high blood pressure, and high blood cholesterol. Other risk factors, such as overweight, diabetes, and physical inactivity, are also controllable to some extent. Although growing older is a risk factor that can't be changed, other risks can be reduced at any age.

Major Risk Factors

Smoking. More than 23 million American women smoke. Cigarette smoking triples the risk for heart attack, and research now shows that women smokers seem to have a higher risk of heart attack than men who smoke.

Older women and those with other risk factors for heart disease are at greatest risk. Women who smoke and use oral contraceptives, particularly women age 35 and older, are also at higher risk.

There is nothing easy about giving up cigarettes. But as hard as quitting may be, the results are worth it. In the first year after stopping smoking, the risk of heart disease drops sharply. It then gradually returns to normal—that is, the same risk as for someone who never smoked. This means that no matter what your age, quitting will lessen your chances of developing heart disease.

Many women successfully quit smoking on their own, but you also may do well in a group setting. There are a number of free or low-cost programs available that can help you stop smoking. Additionally, ask your doctor whether you are a candidate for medication, nicotine gum, a nicotine patch, or nicotine nasal spray. These aids can help you stay smoke-free by lessening withdrawal symptoms while you get used to life without cigarettes.

Second-hand smoke is also a problem. It is estimated that each year up to 40,000 people die from heart disease caused by other people's smoke. To avoid second-hand smoke, try the following strategies:

• Ask people not to smoke in your home.
• Choose the no-smoking section in restaurants and other public places.
• Seek a smoke-free work environment, or try to change the smoking policy at your current workplace.

High blood pressure. More than one-third of women age 20 to 74 have high blood pressure. The condition is more common and more severe in African-American women than it is in white women. Four out of five black women age 45 and older have high blood pressure.

High blood pressure is sometimes called the “silent killer” because most people who have it don't feel sick. It is important to have your blood pressure checked each time you see your doctor or health professional. Although high blood pressure can rarely be cured, it can be controlled with proper treatment. If it is not too high, you may be able to control it through weight loss (if you are overweight), regular exercise, and cutting back on alcohol, table salt, and packaged foods containing sodium. If your blood pressure remains high, however, your doctor may prescribe medicine in addition to the above changes.

High blood cholesterol. Young women tend to have lower cholesterol levels than do young men. However, between the ages of 45 and 55, women's levels begin to rise, surpassing men's. After age 55, the gap between women and men becomes even wider. Today, about one-fourth of all American women have blood cholesterol levels high enough to pose a serious risk for heart disease.

All women age 20 and older should have their blood cholesterol level checked. A complete lipid/cholesterol profile will show total cholesterol level as well as the levels of “good” cholesterol (HDL), “bad” cholesterol (LDL), and triglycerides. Experts are not certain whether triglycerides are a risk factor for heart disease by themselves. However, having high triglycerides may increase the risk for women more than for men.

A desirable blood cholesterol level for adults without heart disease is less than 200. A level of 240 is considered high, but even levels between 200 to 239 boost the risk of heart disease.

For many people, cutting back on foods high in cholesterol and fat, especially saturated and trans fats, can lower cholesterol. Saturated fats, found mainly in animal products, and trans fats, which are found in margarine and commercially prepared baked goods, should be replaced with monounsaturated and polyunsaturated oils. The “monos” are found in olive and canola oils. The “polys” are found in soy and corn oils. Regular exercise also can help lower cholesterol levels, as can weight loss if you are overweight.

If these lifestyle measures do not lower cholesterol level enough, your doctor may prescribe cholesterol-lowering medications. This recommendation will depend on whether you have any other risk factors for heart disease.

Additional Risk Factors

Overweight. Women who are overweight are more likely to develop heart-related problems, even in the absence of other risk factors. In one study, almost 40% of heart disease cases were attributed to overweight.

According to research, the risk for some health problems begins to rise with a weight gain of more than 10 pounds after age 18. An 11-pound gain—just one pound's difference—may significantly increase the risk of heart disease. Overweight women are also more likely to develop high blood pressure and are more apt to have high blood cholesterol and diabetes—additional risk factors for heart disease.

Research also suggests that body shape as well as weight affects heart health. “Apple-shaped” individuals with extra fat at the waistline may have a higher risk than “pear-shaped” people with heavy hips and thighs. If your waist is as large or larger than your hips, you may have a higher risk for heart disease.

Diabetes. The risk of death from heart disease is doubled in women with diabetes. In fact, a woman with diabetes has as much as a seven-fold increased risk of developing heart disease, a much greater risk than that seen in men with diabetes. Researchers suspect it may be because the disease has a more harmful effect on women's blood cholesterol levels and blood pressure.

While there is no cure for diabetes, it can be controlled. And losing excess weight and boosting physical activity may actually help postpone or prevent the disease.

Stress. While research has not proven the theory that type A behavior (aggressiveness, a need to compete, and a constant concern about time) is linked to the development of heart disease, recent research has found that hostility and anger are risk factors. It has not been proven that this holds true specifically for women, however.

Some common ways of coping with stress, such as overeating and heavy drinking, are bad for the heart. On the other hand, stress-relieving activities such as exercise and relaxation techniques can lower heart disease risk.

Other Prevention Strategies

Exercise. Physical inactivity increases the risk of heart disease. Exercise can help you take off extra pounds, control blood pressure, prevent and control diabetes, and boost the level of “good” HDL-cholesterol.

You do not have to be a super-athlete to reap the benefits of physical activity. Everyday activities like brisk walking, biking—even raking leaves and housecleaning—are effective. Exercise 30 minutes a day on most, preferably all, days. The 30 minutes can be in one block of time or in shorter periods of at least 10 minutes each.

Alcohol. A number of studies have reported that moderate drinkers are less likely to develop heart disease than people who don't drink any alcohol or who drink too much. Small amounts of alcohol may help protect against heart disease by raising levels of HDL cholesterol. Moderate drinking for women is defined as one drink per day. Counted as one drink are 12 ounces of beer, 5 ounces of wine, or 1-1/2 ounces of hard liquor (80 proof).

This is not a recommendation to start using alcohol if you are a non-drinker. And if you are pregnant or have another health condition that could make alcohol use harmful, you should not drink. But if you're already a moderate drinker, evidence suggests that you may be at a lower risk for heart attack. Moderation is the key; heavy drinking can cause heart-related problems.

Hormones and menopause. Menopause is characterized by a decrease in estrogen produced by women's ovaries. As estrogen levels begin to fall, some women develop symptoms such as hot flashes and mood swings. Research has found that prescription hormone medications can be used to relieve these symptoms and prevent or slow osteoporosis.

Some research indicates that estrogen, the key component in hormone replacement therapy (HRT), helps protect women from heart disease. However, in the first year of hormone therapy, women who already have heart disease may face an increased risk of heart attack. In addition, estrogen may be a factor in the development of uterine and breast cancer and gallbladder disease.

Until there is more conclusive research, the decision to use HRT must be made between each woman and her physician. If you are considering this treatment, you will need to consider your overall health and your personal and family health history.

Aspirin. A study of more than 87,000 women found that those who took aspirin regularly were 25% less likely to suffer a first heart attack than women who took no aspirin. A tiny daily dose of aspirin may be all that is needed. One study found that taking only 30 milligrams daily was as effective as the usual 300-milligram dose and caused less stomach irritation. As aspirin is not safe for everyone, however, you should not begin to take it on a long-term basis without consulting your physician.

A Personal Action Plan

Preventing heart disease, by and large, means making difficult lifestyle changes. A healthy heart requires a personal action plan. But where does one begin?

A complete medical checkup is a sensible first step. With the help of your doctor, you can find out if you have any coronary disease risk factors, and if so, work out a practical approach to prevention. Even if you have no risk factors now, you can discuss ways to lesson your chances of developing them.

But while advice from a health professional is important, a major portion of responsibility for a healthy heart rests with each individual woman. She alone can make the changes in eating, drinking, smoking, and exercise habits that will help protect her against coronary disease.

Women are taking a more active role in their own health care. They are asking more questions and are seeking more self-help solutions. They are concerned not only about treatment, but about the prevention of a wide range of health problems. Taking steps to prevent coronary disease is part of this growing movement to promote and protect personal health. The rewards of healthy heart are well worth the effort.