Wednesday, May 11, 2011

A Woman's Guide to Beating Heart Disease

Surveys show fewer than one in 10 women perceive heart disease as their greatest health threat. But it's the nation's number one killer, and women are its prime target. One in 10 women ages 45 to 64 has some form of heart disease, and this increases to one in four women after age 65. Stroke is the number three killer of women.

"Every year, more women die of heart disease and stroke than men," says Rose Marie Robertson, M.D., spokesperson for the American Heart Association (AHA). "The overall lifetime risk of dying from breast cancer for women is 3 percent. For cardiovascular disease or stroke in women, it's nearly 50 percent."

The risk of heart attack and stroke increases with age, especially after menopause. But atherosclerosis, the condition in which plaque -- thick, hard cholesterol deposits -- forms in artery walls to restrict or block blood flow and cause chest pain or even a heart attack, starts in your teens and 20s. That's why it's important to start protecting yourself from heart disease early.

Check your risk

First, you should get your blood cholesterol and blood pressure checked. The higher either of them is, the greater your risk for heart disease or heart attack. A lipoprotein profile, a blood test done after a 9- to 12-hour fast, will measure the fats in your blood to indicate your levels of total cholesterol, LDL ("bad") cholesterol, HDL ("good") cholesterol and triglycerides, another form of fat in the blood.

In general, you're at low risk if your total cholesterol is less than 200 mg/dL; LDL, less than 100 mg/dL; HDL, greater than 40 mg/dL (but preferably greater than 60); and triglycerides, less than 150 mg/dL.

Normal blood pressure is 119/79 or lower. Pre-hypertension, which means it is likely that high blood pressure will develop in the future, is 120 to 139 for the top number and 80 to 89 for the lower number. High blood pressure, or hypertension, is 140/90 or higher.

But your lipoprotein profile tells only part of the story. Your doctor will use your profile in combination with other data, such as your medical history and family history of heart disease, to assess your risk and determine whether to recommend cholesterol-lowering medication. Your doctor may advise you to make diet and lifestyle changes before prescribing medication.

"For most women, heart disease is preventable by making lifestyle changes that can reduce their risk," says Dr. Robertson.

She offers the following ways to head off this killer.

Lose weight

Being overweight increases blood pressure, and blood cholesterol and triglyceride levels. It also increases your risk for type 2 diabetes, a condition in which your body can't use insulin to transport glucose into cells, where it can be used for energy. Type 2 diabetes itself increases your risk for clogged arteries and heart attack.

"By bringing your weight down to its optimal level, you'll lower your cholesterol level and blood pressure and make your body more sensitive to the effects of insulin," says Dr. Robertson.

A body mass index (BMI) of 25 to 29.9 is considered overweight. A BMI of 30 or higher is considered obese. To calculate your BMI, multiply your weight in pounds by 703. Divide the result by your height in inches, then divide that result by your height in inches again.

Don't worry if you need to lose a lot of weight. "Even losing 5 to 10 pounds can make a difference," says Dr. Robertson.

She suggests eliminating 500 calories per day, which adds up to one pound of excess weight a week, by burning 200 calories through exercise and cutting 300 calories from your diet.

Quit smoking

Smokers have more than twice the risk for heart attack than do nonsmokers. The chemicals in cigarette smoke can shrink coronary arteries, making it tough for blood to circulate.

"Smoking can also cause the lining of blood vessels to become stickier, which makes blood clots more likely, which can cause stroke," says Dr. Robertson.

Get active

At least 30 minutes of moderate physical activity most days of the week does more than help you burn calories.

"It can reduce your risk of heart disease by raising your HDLs," says Dr. Robertson. "It can also reduce LDLs."

Change your fats

Switch the fat in your diet from butter and other saturated fats to liquid margarine, tub margarine, olive oil and canola oil. But use them sparingly because all fats are high in calories.

"Like butter, each contain roughly 100 calories per tablespoon, and too much dietary fat of any kind can contribute to weight gain," says Dr. Robertson.

Also, limit full-fat dairy products, fatty meats, palm oil and partially hydrogenated vegetable oils. Check the label on convenience and other prepared foods, which tend to be high in fat.

Eat your fruits and veggies

Eat plenty of produce -- a moderately active woman should eat at least 3 cups of vegetables and 2 cups of fruits daily. Studies link diets high in fruits and vegetables with lower blood pressure and a reduced risk for heart disease.

Fiber up

Oatmeal, whole-grain bread and other whole-grain foods are excellent sources of soluble fiber, which helps reduce LDL cholesterol. The U.S. Department of Agriculture's Dietary Guidelines for Americans recommend that adults have 6 to 9 ounces of grains per day. Half of this amount should be whole grains.

Drink alcohol in moderation

Women should limit alcohol to no more than one drink per day, the equivalent of 12 ounces of beer, 4 to 5 ounces of wine or 1-1/2 ounces of 80-proof spirits.