For Women: Take This Risk to Heart

Cardiovascular disease is women's top killer. According to the National Heart, Lung, and Blood Institute (NHLB), eighty percent of women between the ages of 40 and 60 have at least one risk factor for heart disease, but many do not realize it. And fewer than 60 percent of women even realize that heart disease is the top killer of women. 

Women also don't know about the sometimes subtle signals of a heart attack.

Why the disconnect? In general, heart disease has been perceived as an older person's disease that need not concern women until menopause. For years, women also thought hormone therapy (HT) would protect them from heart trouble. But heart attacks can and do occur at any age, and we now know that HT may actually increase the risk of heart disease.

The most common form of heart disease is coronary artery disease, which affects the blood vessels of the heart. Heart disease also includes atherosclerosis, or the thickening and hardening of the arteries, as well as stroke and heart failure. The groundwork for heart disease can start in your 20s.

Risk factors

Risk factors for heart disease can be divided into those that suggest a major risk and those that lead to an increased risk. Major risk factors are high blood pressure, high blood cholesterol, diabetes, obesity or being overweight, smoking, physical inactivity, heredity, and age. Factors that could lead to an increased risk include stress and excessive alcohol consumption—for women, that means more than one drink a day.

Starting at age 20, women should know their blood pressure and cholesterol levels. One red flag is a high level of LDL ("bad") cholesterol, which clogs arteries, and a low level of HDL ("good") cholesterol, which clears arteries.

Knowing your risk factors is vital. The more risk factors you have and the worse they are—the higher your blood pressure, for instance—the greater your risk for heart disease.

Once you know your risk factors, you can learn whether you're at high, intermediate or low risk for heart disease. Then you can set goals and work with your doctor to reach them.

Lifestyle changes

The American Heart Association (AHA) guidelines call for cholesterol-lowering drugs or aspirin in some cases, and lifestyle changes at all levels of risk. The National Institutes of Health says these steps could help lower your risk by a whopping 82 percent:

• Lose weight. You'll cut your blood pressure, cholesterol and diabetes risk, hitting three key risk factors at once. For apple-shaped women, losing spare-tire fat is vital. Belly fat has been linked to higher levels of triglycerides, a blood fat that raises your risk for heart disease.

• Trim saturated fat and salt from your menu. When you can, trade butter for heart-healthy canola or olive oil. Swap red meat for seafood, a good source of omega 3 fats shown to help reduce triglycerides, clotting, and blood pressure.

• Get a move on. Exercising 30 minutes five days a week can cut your blood pressure and protect your heart, studies show. In a month, you may see your systolic blood pressure (the upper number) drop eight to 10 points. In six months, your HDL may rise 10 percent.

• Quit smoking. Smoking is women's most common risk factor and triples your heart attack risk. It may take a few tries to quit. You'll need to address your addiction physically, with a patch or gum, for instance. You'll also need to modify your behavior, by munching a carrot when cravings strike, for example.

• De-stress daily. Visit a friend. Light candles and listen to mood music. Take a yoga class. Putting yourself on your "to do" list and finding ways to defuse stress will help slow your breathing and heart rate as you lower your blood pressure.

Heed these symptoms

If you have to sit down after you clear the dishes, a heart attack could be in your near future.

Unshakable fatigue—tiredness that hampers activities—and sleeplessness appear to be early warning signs of a woman's heart attack.  Other symptoms include:

• Shortness of breath (very common in women)

• Nausea

• Uncomfortable chest pressure (instead of sharp chest pain, which is a more typical symptom for men, although it may still occur in women) 

• Pain that spreads to the shoulders, neck, or arms

If you have these symptoms, especially if they last more than five minutes, call 911.