Heart Health

With National Heart Month in February, there's no better time to commit to getting a healthier heart. Top experts share their best advice for every age.

In Your 20s
Establish good habits now and they'll keep you healthy for years to come.

Don't start smoking. It's a no-brainer, yes, but surveys show that women who take up smoking most often do so in their early 20s (not their teens, as used to be true). If you already smoke, get serious about kicking the habit. The sooner you do, the easier it will be.

Make time for exercise. Staying in shape is the cornerstone of maintaining a healthy weight and keeping heart disease at bay. Put it in your schedule as you would any appointment.

Drink in moderation. True, much-touted studies have suggested alcohol consumption may protect against heart disease. But women in their 20s are at low risk of heart attack, so the downsides of drinking far outweigh any benefits. If you drink, limit your intake to one glass of wine, beer, or spirits a day.

Treat depression and anxiety. "There's good evidence that depression and anxiety increase the risk of heart disease in women," says C. Noel Bairey Merz, director of the Women's Heart Center at the Cedars-Sinai Heart Institute, in Los Angeles. Mental-health issues may make it harder for women to follow a healthy lifestyle and may even harm the heart directly. It's best to seek help early.

In Your 30s
This is the time when it's key to assess your risk factors and learn the basics of heart-disease prevention. Know your family history. If relatives have had early heart attacks, it's a warning that you could be at risk. The more you know about your inherited potential for heart disease and any other health problems, the better you will be able to target your prevention efforts. To create a simple online record, visit familyhistory.hhs.gov.

Be a good role model. As busy as your life may be, try to eat well and keep up the exercise regime you started in your 20s. It's worth it to carve out the time -- you'll have more energy. If you have kids, "know that mothers play a big role in setting an example by being active and serving healthy meals," Gordon says. Exercise as a family -- go for long bike rides together or run with a jogging stroller.

Learn CPR. "Many women who are in their 30s are caring for young children as well as aging parents," says Michele Voeltz, an assistant professor of medicine, division of cardiology, at Emory University School of Medicine, in Atlanta. Knowing cardiopulmonary resuscitation (CPR) can save lives; 69 percent of people who suffer heart attacks outside a hospital don't get CPR.

In Your 40s
Even if you haven't always led a healthy life, there's still time to help ward off heart disease and strokes.

Ramp up your activity level. Most of us become less active with age and put on a little weight -- changes that really accelerate after age 45, say University of Houston researchers who followed 3,429 women for 32 years. It's more crucial than ever to find an activity you truly enjoy -- swimming, kickboxing, speed-walking -- and stick with it.

Know your risk. "Risk factors for heart disease, such as high cholesterol, elevated blood pressure, and insulin resistance, tend to show up in women when they're in their 40s," Voeltz says. If you don't know your numbers yet, now is the time to get tested. "If you're in your 40s and have even just one risk factor," Gordon says, "you face increased danger of heart disease."

Set goals for reducing risks. If you need to improve your cholesterol, blood pressure, or body mass index, discuss a realistic plan with your doctor. Then schedule a follow-up appointment to measure your progress.

In Your 50s
This is the decade when most women go through menopause and lose the protection of estrogen. Just being 55 or older is now considered an independent risk factor for heart disease in women, but you can still lower your risk.

Take precautions. If you haven't had much success achieving your top health goals through lifestyle changes, talk to a doctor about medications such as cholesterol-lowering drugs or blood-pressure pills.

Ask about low-dose aspirin. Regularly taking one could reduce your risk of stroke by up to 25 percent, according to the Women's Health Study, sponsored by the National Heart, Lung and Blood Institute. Many experts say it's best to start an aspirin regimen in your mid-50s.

Keep calories in check. After menopause, women typically burn 500 fewer calories a month. That adds up, but the metabolism shortfall can be countered by adding a little more aerobic exercise to weekly workouts and drinking less alcohol -- it's more important than ever to stick with just one glass of it a day.

In Your 60s+
Although this is when cardiovascular disease is most likely to develop, staying on top of your health can prevent serious problems.

Mind the signs. When the National Institute of Nursing Research studied 515 women who had suffered heart attacks, they discovered 95 percent were aware of suspicious symptoms about a month before. Taking those signs seriously and getting medical help could have headed off full-fledged attacks. Common red flags include chest pain, indigestion, weakness in the arms, shortness of breath, and unexplained fatigue. Because heart-attack symptoms vary, pay attention to abrupt changes in how you feel, especially fatigue or weakness that makes usual activities difficult.

Consider screening tests. A variety of evaluations, from treadmill stress tests to scans that detect calcium buildup in arteries, can alert doctors to trouble. "There's no one test that's right for everyone, though," Voeltz says, "and many are being overused." If a physician recommends a particular test, ask why -- and why it's right for you.

Look into supplements. As we age, our bodies are less able to absorb vital nutrients, including some that protect against heart disease. That's why the food pyramid for people over 70 puts calcium, vitamin B12, and vitamin D at the top of the triangle as crucial nutrients for seniors. You can find additional information at nutrition.tufts.edu (search for "older adults food pyramid").

Join a clinical trial. For years, critics faulted researchers for not studying heart disease in women. Now many studies of women are under way, but they're often short on volunteers. Check out the National Institutes of Health's database of current health trials at clinicaltrials.gov. "One of the most important things a woman can do to improve diagnosis and treatment for all women," Voeltz says, "is participate in research.
(From Martha Stewart Living, February 2010)