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Your Age-by-Age Guide to a Healthy Heart

Hidden risks and new save-your-life advice for every decade

WebMD Feature from "Good Housekeeping" Magazine

By Janice Graham

Good Housekeeping Magazine Logo

As you hit one of those big birthdays, you probably worry more about new wrinkles than about less visible body parts — like your heart. But recent research has found that each decade of your life is a crossroads, with new health concerns to worry about. What's more, you need to be aware of these issues — because your doctor may not be. "Many physicians fail to recognize how much a woman's risk factors for heart disease evolve over her lifetime," says Nieca Goldberg, M.D., medical director of New York University's Women's Heart Center.

So throw a party, buy a more potent wrinkle cream, then learn how to keep your heart healthy now — and at each milestone ahead.

Your 30s: Get Smart

You know that your kid's unfinished fries and burger do not qualify as heart-healthy. Ditto for birthday cake, cheese puffs (even if they're organic), and all the other fat-laden, artery-clogging fare you may encounter as a mom of young children. But your biggest heart hazard may be in your head, not on your plate. "Women in their 30s often think they're too young for heart disease, even though they've already developed serious risk factors," says Sarah Samaan, M.D., a cardiologist at Legacy Heart Center in Plano, TX. In fact, as many as 60 percent of women under 40 have at least one high-risk factor, such as smoking, elevated cholesterol, or obesity — which triples their heart attack odds. To lower those chances, you need to know where you stand. Almost 20 percent of women have never had a blood cholesterol test, although the American Heart Association recommends one at least every five years starting at age 20 (see "Your Checkup Checklist," below). You still have plenty of time to shape up before you hit the really high-risk years. Make an appointment with your doctor to review where you stand; then get serious about quitting smoking, losing weight, eating right, and exercising.

Do you need to reconsider the Pill? Yes — if you're over 35 and have high cholesterol, uncontrolled high blood pressure, or a BMI over 30, or you smoke. Oral contraceptives — especially older versions with high doses of estrogen — worsen these heart disease risk factors and increase the chance of blood clots. Newer, lower-dose Pills may be safer, though there aren't data yet to confirm this. But as long as you don't have any of those risk factors, "you can safely use the Pill until age 50 or until you reach menopause," says C. Noel Bairey Merz, M.D., director of the Women's Heart Center at Cedars-Sinai Medical Center in Los Angeles.

Surprising Hidden Risks

• Missed periods. Just about everyone skips from time to time, but women with long histories of irregular cycles at age 35 have a 50 percent greater chance of eventually having a heart attack, a large Harvard study reported. It may be because erratic cycles are frequently linked with obesity. They're also a sign of polycystic ovary syndrome (PCOS), a common hormonal disorder that raises the risk of high cholesterol, high blood pressure, and diabetes, as well as infertility and acne. Medication and weight loss (if needed) can get symptoms under control — and should reduce your heart risk, says Anuja Dokras, M.D., an ob-gyn at the Hospital of the University of Pennsylvania. Still, to be on the safe side, she advises her PCOS patients to get cholesterol and blood sugar checks every other year.

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