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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 continued...

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

Your 50s: Be Symptom-Savvy

Although the transition through menopause can be rough, the hormonal "peace" you finally achieve afterward may be pretty sweet. But there is one sour note: Your risk of heart disease rises two- or threefold. This may be due, in part, to the loss of protection from natural estrogen, but it's also a matter of age and other risk factors finally catching up with you. The bottom line: It's time to learn what a heart attack feels like. "Women often delay dialing 911 because they doubt their symptoms signal a heart attack. And that hesitation can cost you your life," says Dr. Goldberg. Aside from the classic warning signs — a bursting chest pain that spreads to jaw, neck, and shoulder — look for these subtler symptoms, which can build in intensity over days or weeks: unusual fatigue, nausea, dizziness, shortness of breath, heaviness in the chest, or upper abdominal pain.

Should you start taking a baby aspirin? If you're younger than 55 and have never had a stroke or heart attack, probably not. Even aspirin that is buffered or enteric-coated increases the risk of life-threatening gastrointestinal bleeding — up to four times if you also take another NSAID such as ibuprofen, the U.S. Preventive Services Task Force just reported. But if you're older than 55, when heart attacks and strokes become more common, a daily aspirin might make sense. Ask your doctor to help you weigh the pros and cons.

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