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New Guidelines on Women’s Heart Risk

American Heart Association Warns of Heart Attack Risk for Women With Some Pregnancy Complications

Dietary Recommendations for Women continued...

“It is a bit radical, especially the sodium intake,” says Suzanne Steinbaum, MD, director of women and heart disease at Lenox Hill Hospital in New York City. Steinbaum reviewed the guidelines for WebMD but did not serve on the writing committee.

“The sugar issue is in response to the obesity epidemic and is a way to get women to pay attention to the effects of sugars on the metabolic syndrome and weight gain,” she says.

The updated guidelines also state that folic acid and antioxidant vitamins such as vitamin E, C, and beta-carotene should not be used to prevent cardiovascular disease in women. What’s more, hormone replacement therapy should not be used to prevent heart attacks or strokes.

“If you eat a healthy diet, you don’t need supplements,” Steinbaum says. “Folic acid may reduce levels of homocysteine, but it does not seem to translate to a lower risk for heart disease.” Homocysteine is an amino acid in blood that had been linked to heart risk.

Aspirin and Women

Daily aspirin therapy prevents a recurrent problem in men and women who already have heart disease, Mosca says. But “there is softening of the guidelines when it comes to aspirin as a way of preventing heart disease in otherwise healthy women.”

“The decision about aspirin should take into consideration if she has controlled blood pressure or any risk of gastrointestinal bleeding because these are aspirin side effects that are very common and we don’t want doctors to just jump on it and tell all women to take an aspirin a day,” she says.

“We now understand that while women have been shown to respond similarly to men for many interventions, they may have different side effect profiles,” she says. Many women are not taking medications as prescribed or recommended because of side effects or fear of side effects.

“There is a real call in the guidelines for scientists and policy makers to have data by gender for positive and negative side effects,” Mosca says.

The bottom line is clear. “You do not need to develop heart disease no matter what your family history is,” Steinbaum says. “You need to live a healthy life and if you watch your risk factors, exercise and eat a healthy diet, heart disease doesn’t need to happen to you.”

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