- Family history. A family history of early heart disease (under 55 for male relatives and especially female relatives under 65) is a strong predictor of your risk.
- Age. Your risk increases each year, but it jumps at menopause when fat is often redistributed to the abdomen. Until menopause women have a 10-year advantage over men; a pre-menopausal 47-year-old woman has the same risk as a 37-year-old man.
- Race. African-American women have the highest risk of both developing and dying from coronary heart disease.
- Diabetes. Diabetics are three to seven times more likely to die from heart disease. The number of people diagnosed with diabetes increases by 10 percent a year.
- Hypertension. High blood pressure doubles the risk of heart disease and heart failure.
- Elevated cholesterol, LDL and triglycerides. These three lipids act as a triple threat to your heart.
What you can do
Fortunately, there are many things you can control in the fight against heart disease. Continuing to exercise and eat well is a given, but you should also do the following:
Control your cholesterol and triglyceride levels
Low HDL (high-density lipoprotein) cholesterol and high triglyceride levels are stronger predictors of heart disease in women than in men. So, if you haven't had a fasting lipid profile done recently, call your doctor to schedule one. The test will show your total cholesterol, LDL (low-density lipoprotein), HDL and triglyceride levels.
Build-up of LDL (the "bad" cholesterol) can block your arteries. But HDL is like a "vacuum cleaner that goes through the blood vessels and gobbles up fat and plaque," says Judelson. The higher the HDL level, the better. In fact, the impact of a high HDL is so great in women that it may blunt the effect of an elevated LDL. Try to maintain an LDL of less than 100 and an HDL of greater than 50.
Triglycerides, on the other hand, are not cholesterol, but a type of fat in the blood. They're basically excess calories stored in fat tissues for later use. Elevated triglyceride levels cause blood to become more viscous and thus more likely to clog the arteries of the heart. Try to keep your triglycerides below 150.
The National Heart, Lung and Blood Institute advises that all women over 20 have a fasting lipid profile done. How often you get one varies with age and risk factors, so ask your doctor to recommend a schedule.
Control your blood pressure
Even slightly elevated blood pressure increases your risk for heart disease and stroke. Compared to a healthy blood pressure of 115/75 or below, a 20-point increase in systolic blood pressure (the top number) or a 10-point increase in the diastolic blood pressure (the bottom number) doubles the risk of heart attack and stroke. Keep your blood pressure under 120/80 by controlling your weight, eating plenty of fruits and vegetables, keeping sodium down, exercising and taking medications if prescribed.
There are two parts to a healthy diet. First are the components you should avoid or limit, such as saturated and trans fats, sodium, excess calories and added sugars. But a healthy diet is more than just limiting some foods. It's also eating ample fruits, vegetables, whole grains, plant proteins and fatty fish (salmon, tuna, herring). A study last year noted that including these foods in a low-fat diet reduced total and LDL-cholesterol more than a low-fat diet alone.
Research has found omega-3 fatty acids in fish oils especially effective in reducing the risk of heart disease. "I recommend fish oil supplements to all of my patients, to their family members and to everyone else who will listen," says cardiologist Anderson Morris, director of HealthSouth Heart College in Birmingham, Ala. Two thousand milligrams of fish oil daily equals two fish serving per week. Morris also recommends a multivitamin/mineral supplement.