Heart disease is the number one killer of women in the United States—and yet the American Heart Association just released its first statement highlighting women and heart disease. Because of gender bias and stigma, heart disease has always seemed like a man’s problem.
But it's not. Women of all ages and ethnicities are at risk. Still, there's some good news: it's likely that heart disease is preventable 80 percent of the time. By taking the necessary steps and precautions, women can cut their risk of heart disease dramatically.
Prevention is key, and knowing and managing your modifiable risk factors is the best medicine. As a practicing cardiologist, here's what I recommend:
1. See your doctor once a year.
Women of every age should have an annual well-woman checkup. Your doctor will perform a thorough physical exam and assess your weight, blood pressure, blood sugar, and cholesterol. Take the time to talk to your doctor about your family health history, which is a strong predictor of heart disease. For example, if your father died of a heart attack before the age of 55 or your mother before the age of 60 you should be screened for heart disease.
Also provide your doctor with a pregnancy history. Did you have high blood pressure, pre-eclampsia, or gestational diabetes? We now know these to be risk factors for heart disease later in life.
Your doctor should also know about all of your symptoms big or small. A woman's symptoms of a heart attack can actually be very different from a man's. While both men and women still have chest pain as the number one symptom, women are much more likely to have shortness of breath, indigestion, fatigue, and palpitations than men are. You know your body better than anyone. Tell your doctor if you have that “feeling” something is not quite right.
2. Find a heart-healthy eating plan, like the Mediterranean or DASH diet.
The Mediterranean Diet is heart healthy, and easy to follow. Stick to a primarily plant-based diet, rich in legumes, nuts, whole grains, fruits, and vegetables. Cook with olive oil instead of butter, and try using spices and herbs to flavor your food instead of salt.
For women with high blood pressure (hypertension), the DASH diet, or Dietary Approach to Stop Hypertension, has been proven to lower blood pressure by a few points in just two weeks. While similar to the Mediterranean diet in substance, DASH also emphasizes minimizing portions to less than 2,000 calories per day as well as cutting sodium intake to less than 2,300 mg per day.
You don't need to completely revamp your diet overnight. Simply start by eliminating junk food, processed foods, and foods high in saturated and trans fats. Replace some meals and portions using the guidelines from these diets, and pretty soon you'll find yourself eating healthier and feeling better!
3. Stop smoking ASAP!
I cannot stress enough how damaging smoking is for the body. Smoking more than doubles a woman’s risk of heart attack and stroke. It increases blood pressure, promotes plaque buildup in your blood vessels, and lowers the good (HDL) cholesterol in your body.
Not to mention that it ages your skin, causes wrinkles, smells terrible, and gives you bad breath. As hard as quitting smoking can be, the overall sense of wellness, health, and freedom that comes with smoking cessation is worth it. Ask for help and start a cessation program ASAP.
4. Make "get moving" your mantra.
Physical activity is essential to heart health. We know that women who are overweight by more than 30 pounds are at increased risk for heart disease (even in the absence of other risk factors). But more importantly, I tell my patients to be active.
Fitness over thinness is the beginner’s rule. Physical fitness brings so many rewards to women of all ages, and usually the weight loss follows. It doesn’t take much. Brisk walking for 30 to 40 minutes a day, four to five times a week is a great start. Feeling fit brings confidence, strength, coordination, and balance and improves blood flow, fatigue, sleep, and stress.
5. Practice daily stress management.
Stress and depression are risk factors for heart disease. That's because stress releases cortisol, the “fight or flight” hormone, resulting in faster heart rate, increased blood pressure, and release of sugar into the blood stream. Chronic overexposure to cortisol is damaging to the heart, brain, and blood vessels. Stress also causes inflammation, which we know contributes to plaque formation in the coronary arteries.
Find an easy stress-relieving technique that works for you. I tell my patients to try light stretches, yoga, or meditation. It can be as simple as finding a quiet space in your house, workplace, or outdoors and taking 15 to 20 minutes to sit quietly alone and breathe.
If you are feeling depressed or overwhelmed, you need to discuss it with your doctor. There are so many ways to treat depression, and there's no reason to suffer in silence. Once properly treated for depression, you should find it easier to get the motivation to start an exercise and diet program.