Preventing Heart Disease in Women

Getting serious about heart health may seem like a huge project because it often means making changes in health habits. It’s a major effort for many people, but it doesn’t have to be an overwhelming one. Some people find it easier to tackle one habit at a time. For example, if you smoke cigarettes and also eat a high-fat diet, work on kicking the smoking habit first. Then, once you’ve gotten used to life without cigarettes, begin skimming the fat from your diet.

Don’t Smoke

Quitting isn’t easy, but it’s not impossible. One year after you stop smoking, your risk of coronary heart disease will drop by more than half. Within several years, it will approach the heart disease risk of someone who has never smoked. This means that no matter what your age or how long you’ve smoked, quitting will lessen your chances of developing coronary heart disease.

There are many free or low-cost programs available to help you stop smoking. Check with local chapters of the American Lung Association and the American Cancer Society, local hospitals, your health plan, your workplace and community groups with an interest in health.

A Weighty Concern

Many women fear that if they stop smoking, they’ll gain unwanted weight. But most ex-smokers gain less than 10 pounds. Some people eat more when quitting because they substitute high-calorie food for cigarettes. Choosing lower-calorie foods and increasing your level of physical activity can reduce the amount of weight you gain. When you think about the enormous health risks of smoking, the possibility of putting on a few pounds is not a reason to continue. 

Manage Your Blood Pressure

More than half of American women will develop high blood pressure at some point in their lives. Women who have the highest risk of developing high blood pressure are African American, have a family history of high blood pressure, are overweight or have high-normal blood pressure (130-139/85-89). Blood pressure tends to get higher as you age, but it need not.

High blood pressure can rarely be cured, although it can be controlled with proper treatment. If your blood pressure is not too high, you may be able to control it through weight loss if you’re overweight, regular physical activity and cutting down on alcohol, salt and sodium. By taking preventive steps, you can maintain a healthy blood pressure throughout life.

Cutting Back

Alcohol

Overall, people who drink heavily on a regular basis have higher rates of heart disease than moderate drinkers or nondrinkers. More than three drinks per day can raise blood pressure, and binge drinking can contribute to stroke.

However, small amounts of alcohol-one drink for women or one to two drinks for men per day-may help protect against heart disease by raising levels of HDL ("good") cholesterol.

If you are a nondrinker, this is not a recommendation to start using alcohol. And certainly if you are pregnant, planning to become pregnant or have another health condition that could make alcohol use harmful, you should not drink. But if you’re already a moderate drinker, evidence suggests that you may be at a lower risk for heart attack. For a variety of health reasons, women who drink should have no more than one alcoholic beverage a day.

Hold the Salt

For people who are sodium sensitive, excess salt intake can lead to high blood pressure. You can help prevent and control high blood pressure by cutting down on table salt and on sodium. Salt (sodium chloride) is our main source of sodium. We get salt (and sodium) mainly in processed foods and by picking up the saltshaker too often. A daily total of one teaspoon of salt, which is 2.4 grams or 100 millimoles (mm) of sodium, or 6 grams of sodium chloride, is more than enough.

Add less salt at the table and in cooking. Reduce the amount a little each day until none is used. When you cut down on salt added to food, your taste will adjust. Try flavor enhancers like spices and lemon juice instead of salt and use fewer sauces, mixes and instant products, including flavored rices, pasta and cereals, because they usually have salt added.

When you see "sodium-free" or "low-sodium" on a label, here’s what it means:

• Sodium-free = less than 5 mg of sodium in a serving

• Low-sodium = 140 mg or less of sodium in a serving

• Very low-sodium = 35 mg or less of sodium in a serving

• Reduced or less sodium = sodium at least 25 percent less per serving than the regular version of that food

• Light or light in sodium = sodium at least 50 percent less per serving than the regular version of that food

• No salt added = no salt is added during processing in a food that usually has salt added

Switch to "lite" salt: It only has 40 percent of the sodium of regular salt and has increased potassium. But even "lite" salt should be used sparingly, especially by people taking medications called angiotensin-converting enzyme (ACE) inhibitors. although salt substitutes containing potassium chloride may be useful for some individuals, they can be harmful to people with certain medical conditions. Ask your health care provider before trying salt substitutes.

Cut the fat

High blood cholesterol is another important risk factor for coronary heart disease that you can do something about. For most people, blood cholesterol levels can be lowered by being physically active, maintaining a healthy weight and by eating less saturated fat, total fat and cholesterol. Saturated fat is found mainly in foods that come from animals. For example, whole milk dairy products, such as butter, cheese, milk, cream and ice cream, contain high amounts of saturated fat. Saturated fat boosts your blood cholesterol level more than anything else in your diet. Eating less saturated fat is the best way to lower your blood cholesterol levels.

The Dietary Guidelines for Americans recommend that you:

• Eat a variety of foods.

• Balance the food you eat with physical activity-maintain or improve your weight.

• Choose a diet with plenty of grain products, vegetables and fruit.

• Choose a diet low in saturated fat and cholesterol, and moderate in total fat.

• Choose beverages and foods moderate in sugars.

• Choose foods with less salt and sodium.

• If you drink alcoholic beverages, do so in moderation.

Generally your blood cholesterol level should begin to drop a few weeks after you start eating the heart-healthy way. How much it drops depends on the amount of saturated fat you used to eat, how high your blood cholesterol was, how much weight you lost if you were overweight and how your body responds to the changes you make. The National Heart, Lung and Blood Institute has more information on blood cholesterol.

A heart-healthy eating plan can decrease your risk of heart disease by reducing high blood cholesterol, controlling blood pressure and taking off extra pounds. In addition, eating habits that are good for your heart may also prevent cancer and a number of other health problems.

Eat for Your Heart

Look at how your family eats now and begin to plan. You don’t have to cut out all high-saturated-fat, high-cholesterol foods. Just substitute one or two low-saturated-fat or low-cholesterol foods each day, and soon you will reach your goal of heart-healthy eating for you and your family. By making the changes slowly, you are more likely to stick with your new eating plan.

Move It

Even mild exercise, like pleasure walking, stair climbing, gardening, yard work, moderate-to-heavy housework and dancing, can help lower your risk of heart disease. To get heart benefits from these activities, do one or more of them every day. More vigorous exercise improves the fitness of the heart, which can lower heart disease risk even more. This kind of activity is called "aerobic" and includes jogging, swimming and jumping rope. Walking, bicycling and dancing can also strengthen your heart, if you do them briskly for at least 30 minutes, three or four times a week. Staying active also helps take off extra pounds, helps to prevent and control high blood pressure, boosts the level of "good" HDL cholesterol and helps to prevent diabetes.

What About Potassium?

Research shows that eating a lot of fruit and vegetables and nonfat or low-fat dairy products can lower blood pressure. Such foods supply plenty of potassium, magnesium, fiber and calcium. Potassium, in particular, seems to prevent high blood pressure. Most women can get enough potassium in foods. Good sources of potassium are fruits, vegetables, some dairy foods and fish. 

Some people should get medical advice before starting a program of physical activity. If you are just beginning an exercise program, discuss your plans with your health care provider. To find out more about physical activity and how to get started, see the National Heart, Lung and Blood Institute’s Web site.

Lose It

If you’re overweight, taking off pounds can lower your chance of developing heart disease in several ways. Shedding pounds can lower both high blood pressure and cholesterol. If you are overweight, losing even 5 to 10 pounds can improve your blood cholesterol levels. Weight loss will also help prevent, or help control, diabetes.

One way to find out if you are overweight is to calculate you Body Mass Index (BMI). This measure gives an estimate of body fat, which is what increases the risk for diseases related to obesity. Overweight is defined as a BMI of 25 to 29.9. A BMI of 30 or more defines obesity.

What’s Your Body Shape?

Research suggests that body shape as well as weight affects heart health. "Apple-shaped" people with extra fat at the waistline may have a higher risk than "pear-shaped" people with heavy hips and thighs. If your waist is as large as the size of your hips, or larger, you may have a higher risk for heart disease. 

Weight loss is advised only to help you reach a healthy weight. The aim is not to promote the discouraging idea that "thin is beautiful," but to show the link between reasonable weight and good health-especially the health of your heart. The healthiest and longest lasting weight loss happens when you take it slowly, losing 1/2 to 1 pound a week. For weight control tips, see the National Heart, Lung and Blood Institute’s Web site.

Nobody always eats the ideal diet or gets just the right amount of exercise. Few smokers can swear off cigarettes without a slip or two along the way. The important thing is to want to make healthy changes. Then, follow a sensible, realistic plan that will gradually lessen your chances of developing heart disease. By taking an active role in your own heart health, you can make a difference.