May 22, 2000 -- To protect yourself from having a heart attack, you need to
reduce your risk factors and know the signs to watch for, says Nieca Goldberg,
MD, a spokesperson for the American Heart Association (AHA). Because coronary
heart disease is the leading killer of women in the United States, being a
proactive patient may very well save your life.
The cholesterol-rich plaque that builds up on the walls of heart arteries --
and that leads to coronary heart disease and heart attacks -- starts to form in
early childhood and builds over a lifetime. When blood can no longer squeeze
through the plaque-narrowed artery or when high blood pressure causes the
artery to burst, a heart attack occurs.
By Amy Engeler
At 3 a.m., with all the houses dark up and down her winding suburban street in West Warwick, Rhode Island, Jo-Ann Frey, 37, lights a candle so she can see well enough to dust her furniture. Careful not to turn on any lights or make noise that might wake up her family, she drifts from room to room with her candle and cleaning supplies, waiting until she feels sleepy enough to climb back into bed. That feeling doesn't come -- and when she hears the alarm in the bedroom go off...
While you can change some risk factors for heart disease -- high blood
pressure, poor diet, uncontrolled diabetes, and inactivity, for example --
there are others you can't, like genetics and age. The more risk factors you
have -- if you're an overweight smoker with high blood pressure, for example --
the higher your chances of having a heart attack.
Don't be shy about starting the discussion about heart health with your
doctor and asking for appropriate testing and treatment. "Preventing heart
disease before it occurs or leads to a heart attack is the best solution,"
says Goldberg. Here are some prevention tips from the AHA:
Stop smoking: Lung cancer isn't the only hazard of cigarette smoking.
Smokers are twice as likely to have a heart attack as nonsmokers, says the AHA.
Many studies show that smoking is a major cause of coronary heart disease,
which leads to heart attack. If you have trouble giving up smoking on your own,
ask your doctor to recommend smoking cessation programs.
Reduce high cholesterol: Cholesterol is a soft, waxy fat found in the
blood. Too much of it can lead to plaque buildup and heart attacks. Ask to have
your cholesterol level tested starting at age 21 and every five years after
that. If it's high (above 200), have it tested more often, and work with your
doctor to reduce it with medication, dietary changes, and exercise.
Treat high blood pressure: Request a blood pressure screening every two
years. If your blood pressure is high, get medication if needed and take it
faithfully. High blood pressure is a serious condition that silently makes the
heart work harder, weakening artery walls and encouraging plaque
Exercise regularly: Most women don't get nearly enough exercise to promote
a healthy heart. How much do you need? The AHA recommends no fewer than three
to four sessions per week, at least 30 minutes each. (Make sure to first check
with your doctor to see if it's safe for you to work out).
Maintain a healthy weight: A body mass index (BMI) of between 21 and 25 is
ideal, according to the AHA. (BMI equals a person's weight in kilograms divided
by height in meters squared. A handy BMI chart can be found at: http://www.consumer.gov/weightloss/bmi.htm.)
If your BMI is above 25, you may be at increased risk for heart disease, and
you might want to stick to a sensible diet to bring your weight within the
recommended range. If you have trouble losing weight on your own, ask your
doctor for suggestions.
Control your diabetes: Diabetes raises your risk of heart disease,
especially if you are careless with your medication or diet. Talk to your
doctor about how you can reduce your risk.
Know your genetic risk: If close family members (grandparents, parents,
siblings) have had heart disease, you may be at additional risk. Make sure to
let your doctor know your family history. But remember, not having family
members with heart disease doesn't make you immune; your lifestyle still plays
Consider hormone replacement therapy: Women are at greater risk of heart
attacks after menopause. Hormone replacement therapy (HRT) may reduce this risk
but won't necessarily reverse any plaque buildup already present. Discuss with
your doctor whether HRT is appropriate for you.