Updated Heart Association Guidelines for Women Emphasize Lifestyle Changes

Cardiovascular disease (CVD) has long been identified as the number one killer of women. Ten times more women die annually from heart disease than from breast cancer. In fact, in killing nearly 350,000 American women each year, CVD claims more women’s lives than the next seven leading causes of death combined.

Recently, doctors and other health care professionals have stepped up their efforts to raise awareness of the CVD threat to women. But the focus has been more on short-term response – recognition of warning signs, treatment of existing conditions – than on preventative ways to reverse the troubling health trend.

This year, the American Heart Association has taken a new look at the problem. An expert panel recently issued its revised recommendations. These strongly emphasize lifestyle strategies to reduce risk in all women, not just high-risk women.

• Eat healthy, drink in moderation. A “heart-healthy” diet includes fresh fruits, vegetables and low-fat dairy products. It also restricts salt intake. Alcohol in moderation is not harmful, but don’t overdo it.

• Eat oily fish twice a week. Omega-3 fatty acids are particularly good for your heart. Oily fish such as salmon, trout and fresh tuna (not canned) are an excellent source. Women with heart disease and/or high triglycerides should consider taking a supplement as well.

• Take aspirin. Regardless of CVD risk status, women age 65 or older should consider taking low doses of aspirin. (Previous guidelines did not recommend aspirin in lower risk or healthy women.) High-risk women should up their dosage from 162 to 325 mg per day.

• Reduce saturated fats. Your daily intake should be less than 7 percent of calories.

• Reduce LDL cholesterol. Women with very high risk of CVD should lower their LDL level (low density lipoprotein) to less than 70 mg/dL. This may require cholesterol-lowering drugs.

• Quit smoking. This has always been an AHA guideline, but the update also recommends counseling, nicotine replacement or other forms of smoking cessation therapy.

• Exercise daily, if possible. All women, and especially those with weight problems, should engage in 60–90 minutes of moderate-intensity activity such as brisk walking on most days (and preferably every day) of the week. The update also corrects some myths about CVD prevention. Recent studies now suggest that supplements such as folic acid, vitamin E or C, and beta-carotene do not prevent CVD. Also, hormone replacement therapy and selective estrogen receptor modulators (such as raloxifene for osteoporosis) are not recommended to prevent heart disease in women.