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Hearth & Vascular Center Women's Heart Program

 
Risk Factors
One of the reasons that heart disease kills so many American women is because many women don’t even know that they have it. To find out if you’re at risk for developing cardiovascular disease (CVD), test your Healthy Heart I.Q. An online quiz about CVD risk factors (traits or habits that make a person more likely to develop a disease) is available from the American Heart Association.

The good news is that many of the risk factors for CVD in women can be controlled with lifestyle changes and/or medication.
Type 2 Diabetes
Because women with type 2 diabetes have high levels of insulin in their bloodstreams, they’re more prone to blood clots. This may explain why 75 percent of people with type 2 diabetes die of heart attacks or strokes. Women with diabetes are three times more likely to die of heart disease than women without diabetes. Type 2 diabetes doubles the risk for a second heart attack in women, but not in men.

Although there is no cure for type 2 diabetes, women can control this medical condition by maintaining a healthy weight and exercising regularly. A recent study published in the Journal of the American Medical Association (JAMA) found that women with type 2 diabetes could reduce their risk for heart attack or stroke by exercising regularly. Based on findings from this long-term CVD risk study of 3,000 people, researchers believe that regular exercise may improve a person’s ability to dissolve blood clots and possibly lower the risk for CVD. Exercise makes the body more receptive to the effects of insulin.
Menopause
During menopause, women stop producing the sex hormone estrogen, which offers some protection against heart disease. In recent years, doctors used hormone replacement therapy (HRT) to restore estrogen to premenopausal levels and to reduce a woman’s risk for CVD. But because of recent clinical trials, the American Heart Association recommends that HRT should NOT be used to prevent a second heart attack to reduce a woman’s risk for CVD.
Smoking
If you smoke, you’re two to six times more likely than a nonsmoker to have a heart attack. Consider these facts:

  • Studies show that the more cigarettes you smoke regularly, the greater your risk for heart disease.
  • There’s a direct link between smoking and atherosclerosis.
  • Smokers who take birth control pills are at the greatest risk for a heart attack.
  • Constant exposure to secondhand smoke increases a woman’s risk for CVD.
  • Smoking also boosts the risk for stroke.
Homocysteine
Women with high levels of the chemical homocysteine in their blood may have an increased risk for developing heart disease, stroke, and poor circulation in their hands and feet. Researchers are not sure how high levels of homocysteine affect the heart, but they believe that it damages the arteries, which makes the blood more likely to clot and the blood vessels less flexible. Sometimes high levels of homocysteine run in families; other women may develop the problem after menopause.

A good way to keep your homocysteine levels in check is to eat plenty of foods rich in folic acid (citrus fruits, tomatoes, lentils, beans, and fortified cereals and grains), vitamin B6 (meat, poultry, fish, fruits, vegetables, and grain products), and vitamin B12 (meat, poultry, fish, and dairy products).
High Blood Pressure
Women with high blood pressure face a greater risk for stroke, heart attack, or heart failure. Although high blood pressure is more common in men, postmenopausal women also have a high risk for developing the condition. In many cases, women can help control their blood pressure by maintaining a healthy weight, limiting alcohol intake to one drink per day, exercising regularly, following a heart-healthy diet, and reducing stress. However, some people may require medications to lower their blood pressure.
Chronic Stress
Chronic stress—for example, dealing with a difficult boss—contributes to heart disease by prompting the body to produce “fight-or-flight” hormones, like adrenaline, that constrict coronary arteries and promote blood clots. The good news is that you can help control the stress in your life by eating nutritious foods, getting enough sleep, and exercising on a regular basis. Many women have found relief by taking stress-management courses, as well.
Obesity
Obesity not only doubles your risk for coronary disease and stroke, but it also increases your likelihood for developing diabetes, hypertension, and high cholesterol, which all contribute to heart disease. If you’re overweight, talk to your doctor about sensible ways to lose weight and eat healthfully.
Physical Exercise
Because the heart is a muscle, its performance improves with exercise. Regular exercise helps prevent heart attack and stroke by lowering blood pressure and low-density lipoprotein cholesterol (LDL, the bad kind). Exercise also makes blood vessel walls more flexible and, in turn, helps prevent hardening of the arteries.
High Triglyceride/Cholesterol Levels
Women can reduce their risk for heart disease by controlling their triglyceride levels (levels of the most common type of fat in our bodies). About 25 percent of American women have high cholesterol levels (240 mg/dL or above), and more than half of women over age 55 in the United States need to lower their blood cholesterol. This waxy substance can cause hardening of the arteries (atherosclerosis), the major cause of heart attacks.

Although excess weight tends to increase your blood cholesterol level, heredity and diet also contribute to the condition. High cholesterol can run in families, and a diet high in saturated fat and cholesterol can cause high blood cholesterol levels. The good news is that you can lower your blood cholesterol levels and, in turn, slow, stop, or even reverse buildup in the arteries by adopting a healthy lifestyle. (For more information, see "Cholesterol Management.")
The Deadly Quartet
Obesity, diabetes, high blood pressure, and high triglyceride levels are sometimes called "the deadly quartet." According to a recent study, women are more likely to die if they have only one of the four risk factors, but women with all four have five times the risk for death as men with the "deadly quartet." Additionally, women with this combination are up to 12 times more likely to die than men during the first 10 years following coronary bypass graft surgery.