Heart attack, stroke and other cardiovascular diseases are devastating to women. Coronary heart disease, which causes heart attack, is the single leading cause of death for American women. Many women believe that cancer is more of a threat, but they're wrong. Nearly twice as many women in the United States die of heart disease, stroke, and other cardiovascular diseases as from all forms of cancer, including breast cancer.
The American Heart Association has identified several factors that increase the risk of heart disease and stroke. The more risk factors a woman has, the greater her risk of having a heart attack or stroke. Some of these risk factors you can't control, such as increasing age, family health history, and race and gender. But you can modify, treat or control most risk factors to lower your risk.
| Family history |
If your father or brother was under age 55 or your mother or sister was under age 65 and had a heart attack, stroke, angioplasty, or bypass surgery, you are at increased risk for heart disease. |
| Older age |
Increased age equals increased risk — 55 years and older. After age 65, the death rate increases sharply for women. |
| Smoking |
Smoking is the single most preventable cause of death in the United States. Smoking is a major cause of cardiovascular heart disease among women. Constant exposure to secondhand smoke also increases the risk, even for nonsmokers. Women smokers who use birth control pills have a higher risk of heart attack and stroke than nonsmokers who use them. |
| High blood pressure |
High blood pressure is a major risk factor for heart attack and the most important risk factor for stroke. Women have an increased risk of developing high blood pressure if they are obese, have a family history of high blood pressure, are pregnant, take certain types of birth control pills, or have reached menopause. African-American women have higher average blood pressure levels compared to Caucasian women. Optimal blood pressure is around 120/80. After age 45, 60% of Caucasian women and 79% of African-American women have high blood pressure. |
| Physical inactivity |
Not exercising for at least 30 minutes at a moderate intensity (brisk walking pace) on most days puts you at increased risk for heart disease.
For weight control, women need to exercise with 60-90 minutes of a moderate-intensity activity most days. 70% of American women don't exercise regularly. Various studies show that lack of physical activity is a risk factor for heart disease. Overall, they found that heart disease is almost twice as likely to develop in inactive people as in those who are more active. |
| Diabetes |
After age 45, diabetes affects many more women than men. If you have diabetes, you should aim for an A1c of less than 7%. Adults with diabetes have heart disease death rates two to four times those of adults without diabetes. People with diabetes often have high blood pressure and high cholesterol and are overweight, increasing their risk even more. |
| Blood cholesterol levels (lipids) |
High blood cholesterol is a major risk factor for heart disease. Studies show that women's cholesterol is higher than men's from age 55 on. High levels of LDL (low-density lipoprotein) cholesterol (the "bad" cholesterol) raise the risk of heart disease and heart attack. High levels of HDL (high-density lipoprotein) cholesterol (the "good" cholesterol) lower the risk of heart disease. Research has shown that a low level of HDL cholesterol seem to be a stronger risk factor for women than for men. |
| Overweight |
If you are 20 pounds or more overweight — as are more than one-third of American women — you are at increased risk of heart disease. If you have too much fat — especially if a lot of it is located in your waist area — you're at higher risk for health problems, including high blood pressure, high blood cholesterol, high triglycerides, diabetes, heart disease, and stroke. |
| Metabolic syndrome |
Having at least three of the symptoms below places you at risk for metabolic syndrome, which puts you at increased risk for diabetes and other serious health problems:
- High blood sugar (more than 100 mg/dL after fasting)
- High triglycerides of at least 150 mg/dL
- Low HDL (less than 50 mg/dL in women)
- Blood pressure of 130/85 or higher
- Waist more than 35 inches
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| Premature menopause |
Either natural or through surgery, early menopause (before age 40) is associated with increased risk for cardiovascular disease. |
| Birth control pills |
When combined with regular exposure to cigarette smoke, taking birth control pills greatly increases risk of heart attack and stroke, especially after age 35. |
| Stress |
Having a high demand/low control job can result in sustained high levels of stress. Stress is a normal part of life. But how you cope with stress can affect your heart. |
| Excessive alcohol intake |
The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women per day) is lower than in nondrinkers. However, it's not recommended that nondrinkers start using alcohol or increase the amount they drink. Excessive drinking and binge drinking can contribute to obesity, high triglycerides, cancer, and other diseases, raise blood pressure, cause heart failure, and lead to stroke. |
| Unhealthy diet |
A healthy diet consists of
- Eating fruits, vegetables, and whole-grain, high-fiber foods (aim for 5 servings of vegetables and 2 servings of whole fruit daily)
- Eating fish, especially oily fish*, at least twice a week
- Limiting saturated fat to <10% of calories, and if possible to <7%; and cholesterol to <300 mg/dL
- Limiting alcohol intake to no more than 1 drink per day
- Limiting sodium intake to <2.3 g/d (approximately 1 tsp salt)
- Avoiding all trans-fatty acids (listed as "hydrogenated oil" in the ingredients section)
*Pregnant and lactating women should avoid eating fish potentially high in methylmercury. Check EPA and USFDA websites for updates and advisories. |
