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Women's Health

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Your Age-by-Age Guide to a Healthy Heart

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

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.

But what about ovarian cancer? "The heart protection far outweighs the less than 1 percent lifetime risk of ovarian cancer," notes lead author William H. Parker, M.D., of the John Wayne Cancer Institute in Santa Monica, CA. The exception: If you have a relative — a mother, sister, grandmother, aunt, or cousin — who's had ovarian or breast cancer, especially before menopause, then it might make sense for you to have your ovaries out, says Dr. Parker.

• Breast calcifications. If your mammogram shows specks of calcium deposits in the arteries of your breast, you might not have to worry about cancer, but you do need to pay more attention to your cardiovascular health: You may have more than triple the risk of heart disease of a woman without these deposits, a recent University of Missouri School of Medicine study found. Don't count on your primary-care doc to alert you: Even if the calcifications are noted on the mammogram report (and they may not be), since they're not cancerous, your doctor may not mention them, says lead author Paul S. Dale, M.D. But you shouldn't miss out on this chance for lifesaving information. "Ask if vascular calcifications were noted, and if they were, ask if your heart health needs to be looked at differently," says Dr. Dale.

Start screening early — then don't slack off. These are the tests all women should have, says the American Heart Association, but ask your doctor about special exams or more frequent checks if you're at higher risk.

In Your 40s
• Routine screens: Follow the schedule for your 30s
• Glucose: every three years starting at 45
• A "global risk estimation" — the score that indicates your odds of having a heart attack in the next 10 years. Repeat every five years

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