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Heart disease in women: Understand symptoms and risk factors

What can women do to reduce their risk of heart disease?

There are several lifestyle changes you can make to reduce your risk of heart disease:

  • Exercise 30 to 60 minutes a day on most days of the week.
  • Maintain a healthy weight.
  • Quit or don't start smoking.
  • Eat a diet that's low in saturated fat, cholesterol and salt.

You'll also need to take prescribed medications appropriately, such as blood pressure medications, blood thinners and aspirin. And you'll need to better manage other conditions that are risk factors for heart disease, such as high blood pressure, high cholesterol and diabetes. Some women at high risk of heart disease may also benefit from the use of supplements, such as omega-3 fatty acids.

What type of exercise should you do to reduce your risk of heart disease?

In general, you should do moderate exercise, such as walking at a brisk pace, for 30 to 60 minutes most days of the week. If you can't get all of your exercise completed in one session, it's fine to break up your physical activity into several 10- to 15-minute sessions. You'll still get the same heart-health benefits.

There are other small changes you can make to increase your physical activity throughout the day. You can take the stairs instead of the elevator, walk or ride your bicycle to do errands, or try some sit-ups or push-ups while watching television.

What's a healthy weight?

What's considered a healthy weight varies from person to person, but having a normal body mass index (BMI) is helpful. This calculation helps you see if you have a healthy or unhealthy percentage of body fat. A BMI of 25 or higher can be associated with an increased risk of heart disease. Losing just 10 to 15 pounds can help by lowering your blood pressure and helping to prevent diabetes — both of which increase your risk of heart disease.

Is the treatment for heart disease different for women?

In some women, plaques build up as an evenly spread layer along artery walls, which isn't treatable using procedures such as angioplasty and stenting designed to flatten the bulky, irregular plaques in some men's arteries. For some women, drug treatment — rather than angioplasty or stenting — may be a better option.

Certain heart medications, such as clot-busting drugs (thrombolytics) tend to be more effective in women than in men. Aspirin therapy benefits both men and women, but there's also a difference between men and women in the effects of aspirin therapy. In women, aspirin therapy seems to reduce the risk of stroke more than in men, while in men it reduces the risk of heart attack more than it reduces stroke.

Should women take aspirin to help prevent heart disease?

Guidelines from the American Heart Association urge women to be more aggressive about cutting their heart disease and stroke risks. A daily aspirin can have a number of benefits for women.

A daily aspirin can: Women under age 65 Women age 65 and older
Prevent first stroke X X
Prevent first heart attack   X
Prevent second heart attack X X
Reduce heart disease risk X X

The guidelines recommend that women consider taking aspirin - which means have a discussion with your doctor about the risks and benefits of taking aspirin based on your own individual stroke and heart attack risk. The higher your risk of heart attack or stroke, the more that risk is reduced by taking aspirin, but the higher your risk is of bleeding.

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References
  1. Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation. 2007;49:1230.
  2. Stramba-Badiale M, et al. Cardiovascular diseases in women: A statement from the policy conference of the European Society of Cardiology. European Heart Journal. 2006;27:994.
  3. Wenger NK, et al. Coronary heart disease in women: Update 2008. Clinical Pharmacology & Therapeutics. 2008;83:37.
  4. Frequently asked questions: Heart disease. U.S. Department of Health and Human Services, Office on Women's Health. http://www.4woman.gov/faq/heart-disease.pdf. Accessed Dec. 10, 2008.
  5. Makaryus AN, et al. Diagnostic strategies for heart disease in women: An update on imaging techniques for optimal management. Cardiology in Review. 2007;15:279.
  6. Li TY, et al. Obesity as Compared With Physical Activity in Predicting Risk of Coronary Heart Disease in Women. Circulation. 2006;113:499.
  7. Berger JS, et al. Aspirin for the primary prevention of cardiovascular events in women and men. Journal of the American Medical Association. 2006;295:306.
  8. Antman EM, et al. Use of non-steroidal anti-inflammatory drugs: An update for clinicians: A scientific statement from the American Heart Association. Circulation. 2007;115:1634.

HB00040

Jan. 17, 2009

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