Women's Heart Guidelines

Feb. 20, 2007 -- Heart disease kills 1 in 3 American women, but it doesn't have to be that way.

Women can prevent heart disease and stroke, show the latest guidelines from the American Heart Association.

Armed with new data -- and encouraged by the fact that 60% of U.S. women now know that heart disease is their No. 1 health threat -- the AHA has launched an ambitious prevention program.

The program is the work of an expert panel led by Lori Mosca, MD, MPH, director of preventive cardiology at New York-Presbyterian Hospital and of the Columbia University Center for Heart Disease Prevention.

"Women are still confused about cardiovascular disease prevention," Mosca said at a news conference. "We hope to clear up some of this confusion. These new guidelines will help our patients ... develop strategies to combat this leading killer."

Cardiovascular disease refers to any disease that affects the heart and blood vessels, including stroke.

The AHA women's heart disease prevention strategy has three main elements: living a healthy lifestyle, addressing major heart risk factors, and using appropriate medications.

Here's the plan:

1. All women age 20 and older should see a doctor to find out their heart disease risk.
2. About one in 10 women will learn she is at "optimal risk," meaning she's currently at no real risk of heart disease. These women should continue their heart-healthy lifestyles.
3. Most women will be "at risk" -- meaning they must start thinking about preventing heart disease and stroke. These women must stop smoking, adopt a heart-healthy diet, get at least 30 minutes a day of exercise, and watch their weight. With a doctor's advice -- and only with a doctor's advice -- some of these women may need blood pressure medications, cholesterol-lowering therapy, or regular aspirin.
4. Many women will be "high risk," meaning they already have some condition that makes it particularly likely they will suffer heart disease or stroke. In addition to taking the measures advised for their "at risk" sisters, "high risk" women may need more aggressive medical treatments or rehab.
5. Depression is common in women with heart disease. All women with heart disease should be evaluated for depression.

The new guidelines appear in the March 13 issue of the AHA journal Circulation.

Heart Disease in Women

These guidelines replace the AHA's 2004 guidelines with even more aggressive exercise and diet rules.

"All women should exercise a minimum of 30 minutes a day," Mosca said. For women who want to lose weight, Mosca and colleagues recommend 60 to 90 minutes of exercise "most, or preferably all, days of the week."

As for diet:

• Fruits and vegetables, whole grains, high-fiber foods, and oily fish should make up the biggest part of a woman's diet.
• Saturated fats should be no more than 10% of energy intake -- and 7% would be better.
• Keep cholesterol intake to less than 300 mg per day.
• No more than one alcoholic drink per day.
• No more than 1 teaspoon of salt a day.
• Totally cut out trans fats if you can, but by no means consume more than 1% of total energy from trans fat.

Women with heart disease or high blood-fat levels may consider taking omega-3 fatty acid capsules.