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Your Age-by-Age Guide to a Healthy Heart

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

Your 40s: Get Moving continued...

Alas, working out won't necessarily lead to a dramatic drop in pounds, but research suggests it's key for holding the line — and that may be enough to protect your heart. A study at the University of North Carolina at Chapel Hill found that overweight adults who maintained their weight, gaining no more than five pounds over 15 years, were less likely to have unhealthy changes in their glucose, cholesterol, and blood pressure than those who put on more.

You may have great intentions, but if you're like 78 percent of women, you're not quite fulfilling them. Best trick: Find a routine that you like and that fits into your day. For inspiration, go to goredforwomen.org  and click on BetterU, a free 12-week program you can personalize.

Do you need special screening tests? More and more doctors are turning to cool, high-tech scans to identify new risk markers for heart disease. But a recent analysis from the U.S. Preventive Services Task Force concluded that there is little proof that these improve your treatment. What's more, some tests are potentially harmful: For instance, electron beam computed tomography (EBCT) — a scan that identifies calcium deposits in your arteries — exposes you to radiation equivalent to 10 chest X-rays. "In general, women should skip these tests until there's more evidence they're beneficial," cautions Lori Mosca, M.D., a preventive cardiologist at New York-Presbyterian Hospital in New York City. But that doesn't mean you don't need any tests, especially if you're at high risk. A stress echocardiogram or a nuclear imaging stress test, which are both done as you walk on a treadmill, can provide key warnings about your heart's health.

And doctors for all women should be doing a "global risk estimation" every five years. Basically, this is a mathematical formula used to calculate your odds of having a heart attack in the next 10 years, based on such factors as your age, blood pressure, cholesterol levels, whether you have diabetes, and other risks. Your doctor may or may not share the actual number with you (you can ask), but the information helps her make decisions about the best care for you.

Surprising Hidden Risks

• Hysterectomy. Until recently, women who were having this surgery because of problems like uterine fibroids often chose to have their ovaries taken out along with their uterus, as protection against ovarian cancer. But now there's good reason to rethink that decision: A recent study of almost 30,000 women found that those who had both ovaries removed before age 50 and who never used estrogen therapy had up to a 98 percent higher risk of heart disease than those who kept them. Ovaries continue to make small amounts of hormones for years after natural menopause, guarding against heart disease as well as stroke.

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