While doctors used to think that weight training was bad for the heart because it increased blood pressure, research now shows it can actually lower blood pressure when transforming fat into muscle, which burns calories and keeps them from landing on your belly. This is why Nieca Goldberg, M.D., a New York City cardiologist and author of The Women's Healthy Heart Program, recommends strengthening exercises two or three times a week for all the major muscle groups—arms, legs, shoulders, chest, back, hips, and trunk.
Dr. Agatston suggests a Pilates- or yoga-based regimen that zeroes in on the core muscles of your abdomen and lower back. Either way, consistency is key, as is starting young: Dr. Goldberg says regular strengthening can not only help prevent age-related loss of bone and muscle mass, but also help reduce body fat and improve endurance, both of which can decrease your risk of heart disease.
Step 5: Hey, are those your arteries closing up?
Exercise without diet gets you only halfway to where you need to be. But changing the way you eat doesn't mean starving yourself or signing up for a fad diet. "There's no single food that's going to kill you or save your life," Dr. Hayes says. "Proper diet is about a wide variety of healthy foods." That means, most importantly, avoiding trans and saturated fats: In a 2006 Australian study, researchers found that giving healthy subjects just one fatty meal affected blood flow and diminished HDL's protective qualities.
In its latest dietary recommendations, the American Heart Association suggests that no more than 7 percent of your daily calories come from saturated fats—butter, full-fat dairy like whole milk or cheese, and meat. Meanwhile, only 1 percent of your daily diet should consist of trans fats, which are found mostly in processed foods like cookies, crackers, and chips.
This is why Dr. Goldberg encourages sticking to a "Mediterranean" diet: a moderate amount of foods high in unsaturated fats like olive oil and fish; lean meat, such as beef filet, flank, or sirloin and pork tenderloin, and low-fat dairy; whole grains (think brown rice and barley); and at least five daily servings of colorful fruits and vegetables, which provide antioxidants that help keep blood vessels flexible.
In particular, Dr. Goldberg and others tout the benefits of omega-3 fatty acids, found in salmon and other fish, because they may help lower blood pressure and the risk of abnormal heart rhythms. Dr. Agatston also recommends incorporating foods that lower bad cholesterol, like apples, which research suggests may help prevent plaque buildup; oolong tea, which has strong antioxidant properties that can make LDL particles bigger and less likely to enter the bloodstream; and legumes, such as beans, peas, and lentils, which decrease risk of cardiovascular disease. And he suggests foods such as almonds and walnuts and up to two glasses a day of red wine, which help reduce LDL cholesterol and protect the lining of the arteries.
Step 6: Stop kidding yourself that an occasional cigarette won't hurt.
Yes, you've heard the antismoking rant before. But there's a reason for it. Quitting smoking should top your list of things to do to avoid heart disease, Dr. Hayes says. And that's true even if the only time you light up is over mojitos with friends. Recent research shows that smoking between one and five cigarettes a day triples your chance of dying from a heart attack, and that it's even worse for women than for men. Smoking narrows arteries, raises blood pressure, thickens blood, and makes it more likely to clot—the classic recipe for a heart attack.
This is especially true if you have other risk factors, like high blood pressure and high cholesterol, which together with smoking make you much more likely to get heart disease, according to Dr. Agatston. You take birth control and smoke? You've just put another bullet in the gun. That combo raises blood pressure and can lead to blood clots, further increasing your risk.
While studies have shown that women have a harder time breaking the habit than men, there is encouraging news: A fall 2006 study from the University of Chicago shows that the prescription drug naltrexone—when used in combination with behavioral therapy and nicotine patches—boosted smoking cessation rates among women by 50 percent (though it made no difference in men). Naltrexone also reduced weight gain in the first month after quitting. Talk to your doctor about the drug.