Different ages call for different actions that you can take for a healthy life. 

By Leslie Goldman

Heart disease is a woman’s number one health risk. But don’t let that scare you: Eighty percent of heart attacks and strokes are preventable. Here's what to do to prevent heart disease in your 20s, 30s, 40s, 50s, and beyond.

In Your 20s and 30s

Now’s the time to talk to your doctor about what your heart disease risk factors might be and take a look at your eating, exercise, and lifestyle habits to make any tweaks. The younger you are when you establish good habits, the easier it’ll be to stick with them.

Your Advantages

  • Lots of energy. Make use of it and exercise regularly. This protects your heart by helping keep your cholesterol and blood pressure low. Aim for a combo of cardio and resistance training. The former strengthens your heart; the latter builds muscle, helping you burn more calories (even at rest) and avoid weight gain, which raises the risk of heart attack and stroke. 
  • Hormones. You’ve got a good supply of estrogen, which helps increase HDL (good cholesterol), reduce LDL (bad), and relax blood vessels for strong blood flow.

Keep An Eye On

  • Your stats. Check your cholesterol every five years and your blood pressure and hemoglobin A1c (a test for diabetes, which impacts heart health) every two years so your doctor can see the trend, says Jennifer H. Mieres, M.D., professor of cardiology at the Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell in New York.
  • Pregnancy. If you have complications like high blood pressure, gestational diabetes, preeclampsia or eclampsia, you’re at risk for heart disease, especially five to 15 years postdelivery, and your doctor should monitor you. 
  • Family history. If a parent or sibling has heart disease before a certain age—55 for men, 65 for women— your risk increases. 
  • Drinking. A daily 5-ounce glass of red wine can positively affect cholesterol, but more than that regularly can raise blood pressure. 

In Your 40s

It’s all about hormones. As you enter perimenopause, estrogen levels drop so you have less of its protective effects. Now’s the time to establish a strong relationship with an internist; they’re specifically trained in tracking heart disease risk factors.

Your Advantages

Metabolism. Use this window when your metabolism is still pretty strong to get your eating habits in order. Healthy eating helps offset a slowing metabolism later. A favorite eating plan of cardiologists: The Mediterranean diet, which is plant-based with lots of brightly colored produce (especially green leafy veggies), beans, whole grains, healthy fats, nuts and seeds, and fish (try for twice a week). Lean protein (chicken, turkey) is also recommended, and lean pork and beef are OK in moderation.

Keep An Eye On

  • Your waist. For women, a waist of 35 inches or up has been associated with an increased risk of heart disease. (For men it’s 40 inches.) Whittle your middle with high-intensity interval training (HIIT) twice a week. “It can jump-start weight loss and conditions your heart,” says Sharonne N. Hayes, M.D., founder of the Women’s Heart Clinic at the Mayo Clinic in Rochester, MN. Try alternating three minutes of walking with two minutes running for a total of 20 minutes, and combine it with strength training twice a week, says Dr. Mieres, coauthor of Heart Smart for Women: Six S.T.E.P.S. in Six Weeks to Heart-Healthy Living.
  • Blood sugar. Your risk for type 2 diabetes goes up once you hit 45. And diabetes is more of a risk factor for women than men. (High blood sugar leads to hardening of the arteries.) Get your blood sugar tested at your annual checkup; if your numbers creep up, you can make exercise and diet changes to reverse the trend.
  • Cholesterol. Perimenopause and menopause can increase LDL cholesterol and decrease HDL’s protective benefits. Exercise to the rescue. It raises your HDL, and the more HDL, the more protection we have. Aim for 150 minutes of exercise weekly, but change it up to keep your heart challenged. If you’ve always been a walker, for example, walk faster, on an incline, or work in a few minutes of jogging.
  • Stress. You may feel the pressure of juggling work, family, and even taking care of parents. Research has shown that uncontrolled anxiety (and depression, too) can be an underlying cause of heart disease—in part by raising levels of cortisol, which enhances the buildup of plaque in your arteries. You might not be able to control when tension hits, but you can lessen the damage by weaving stress relief into your schedule, whether it’s listening to music, doing yoga, deep breathing, or meditation.

In Your 50s and Beyond

Women’s risk for heart disease goes up during menopause (around age 51) and begins to match that of men’s. So it’s especially important to keep the heart health conversation going with your doctor at your yearly checkup. Also watch for symptoms, such as feeling unusually tired and short of breath during daily activities.

Your Advantages

  • Less stress. A recent AARP survey revealed that happiness increases starting in our early 50s.
  • More time. If you’re an empty nester or retired, you may find yourself with more free hours. Put them to good use and volunteer. Research shows that people over 50 who volunteer about four hours a week are 40 percent less likely to develop high blood pressure. 

Keep An Eye On

  • Sleep. Adults who net fewer than six hours per night can be more at risk for heart disease than those who log six to eight hours. If menopause-related night sweats are part of the problem, keeping your bedroom at 68°F or lower can help. If you have extreme fatigue during the day and snore, you may want to be checked for sleep apnea, says Melissa Daubert, M.D., director of women’s cardiovascular health and assistant professor of medicine at Duke University Medical Center in Durham, NC. 
  • Immunizations. When you’re older, having the flu can raise your risk of heart issues because it can affect your blood pressure and heart rate. So get an annual flu shot. Adults 65 or older should also be vaccinated for pneumonia. 
  • Vitamin D. More research is pointing to vitamin D deficiency as a factor in heart disease, and older women don’t synthesize D as easily. Get your D levels checked yearly.
  • Calcium supplements. A recent study suggests a possible link between calcium supplements and heart disease; weigh the risks and benefits with your doc and up your calcium intake via food. 

Heart Attack Symptoms In Women

Although chest pain is a main sign for both women and men, women are more likely to experience:

  • Pain in the shoulders, neck, jaw, upper back, or arms.
  • Unexplained dizziness, light-headedness, or fainting, sometimes accompanied by palpitations.
  • Shortness of breath or trouble breathing without chest discomfort.
  • Clammy sweating that feels like sweating when you’re stressed.
  • Stomach pain, abdominal pressure, or nausea.
  • Unusual weakness, fatigue, or inability to perform simple activities.
  • If you or someone you know is having these symptoms, call 911 and say, “I think I am having a heart attack” so the EMTs will come prepared. 
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