Are You Headed Toward Heart Disease?

Take These 6 Steps to Reduce Your Risk

By Jennifer H. Mieres, M.D. and Stacey E. Rosen, M.D.

Here’s a health fact that should get every woman’s attention: Women are far more likely to die of heart disease than from all forms of cancer.

That is a clear indication of how important it is to know how to prevent or minimize your risk for heart disease. But having that urgency can sometimes be difficult because heart disease can masquerade as indigestion, breathlessness, or general fatigue, thereby delaying early diagnosis.

For women, heart disease can present with symptoms other than chest pain or chest pressure. It can develop silently over many years and does not always announce its presence and prompt you to seek treatment.

According to the American Heart Association, 9 out of 10 women have one or more risk factors for heart disease, and 1 in 3 women will die of heart disease. While most women are worried about breast cancer, heart disease will claim the lives of more women than from all cancers combined.

Women and men share certain risk factors: smoking, high blood pressure, diabetes, a sedentary lifestyle, high cholesterol, and a family history of heart problems. But there are important differences that are unique to or more dangerous for women:

• Diabetic women are three to seven times more likely to die from heart disease than diabetic men.

• Women tend to be more obese, more inclined to have a sedentary lifestyle, and more likely to suffer from hypertension and diabetes than men.

• There are sex/gender-specific risk factors for heart disease and heart attacks in women. These include women who have had early menopause and those with pregnancyrelated complications such as gestational diabetes, preeclampsia, and eclampsia. Women with inflammatory or auto-immune diseases, such as lupus or rheumatoid arthritis, are at increased risk for heart disease, as well as women with cardiac issues related to breast cancer treatment and those with stress, depression, and anxiety.

For women, heart disease can present with symptoms other than chest pain or chest pressure. ‘‘ ’’

It’s important to know that heart disease is largely preventable and treatable. Simple lifestyle changes can make a huge impact in reducing risk. One way to incorporate those changes is a program we call Six S.T.E.P.S in Six Weeks to a Healthier Heart.

Week 1: Stock the kitchen with healthy food choices

Open your refrigerator, pantry, and freezer and get rid of all the foods that are high in fat, sugar, and/or sodium. Purge the ultra-processed foods. Foods high in calories and low in nutrients have no place in a heart-healthy kitchen.

Restock with healthy foods, such as fresh fruits and vegetables; salmon and other cold-water fatty fish; whole-grain and sprouted grain breads, pasta, and cereals; high-fiber foods; brown and wild rice; skinless chicken breast; and extra-lean ground chicken and turkey.

Week 2: Take control of your activity

You need a daily routine focused on three types of activity: walking, strength and flexibility training, and moving your body more in general. An eight-year study of more than 70,000 women found that brisk walking and vigorous exercise substantially reduced the incidence of heart attacks.

Ideally, walk 30 minutes a day. Strength training builds muscle mass and improves your metabolism. And remember, prolonged sitting throughout the day can be damaging to your health, even if you already exercise on a regular basis. So find ways to keep your body moving.

Week 3: Eat for a healthier heart

Plant-based foods should be the primary staples in your diet. Eat at home more often and cut back on eating processed foods. Unprocessed foods are whole foods in their natural state. With these foods, the vitamins, minerals, and nutrients are intact.

Remember that eating food and drinking beverages containing large amounts of sugar are directly related to an increased risk of Type 2 diabetes. The American Heart Association recommends that women limit added sugars to no more than 100 calories per day, or 6 teaspoons.

Week 4: Partner with your doctor

If you go to the doctor only when you are sick, rethink that strategy. Far too often, women schedule regular doctor visits for everyone but themselves. It’s time to reprioritize. Remember that many people who suffer fatal heart attacks didn’t even know they had heart disease.

The way to forge a true partnership with your physician is through an annual well-woman visit, giving the doctor a chance to learn about you, examine you for signs of heart disease, and discuss appropriate screening measures.

Week 5: Sleep more

Getting enough sleep is essential for a healthy heart. Too little sleep can make you susceptible to weight gain and increases the risk of Type 2 diabetes and high blood pressure.

The American Heart Association says that most people need seven hours of sleep a night. A 2020 study found that sleep is an important marker of cardiovascular health.

Week 6: Put it all together

Week six is the time to review your successes and evaluate where you have opportunities for improvement. You will learn a lot from your failures when you identify what didn’t work and understand why.

It’s common for one aspect of the program to work better than another when taking on new lifestyle changes over a fairly short period of time. Your commitment to living a heart-smart life is long term, and remember, taking small steps of progress will make a big difference.

Jennifer H. Mieres, M.D., co-author of Heart Smarter for Women: Six Weeks to a Healthier Heart (www.heartsmarterbook.com), is a professor of cardiology and associate dean of faculty affairs at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. She also is a senior vice president and chief diversity and inclusion officer at Northwell Health. Mieres is a leading advocate for patient-centered healthcare and medical education reform and has authored or coauthored over 70 scientific publications.

Dr. Stacey E. Rosen, M.D., co-author of Heart Smarter for Women: Six Weeks to a Healthier Heart (www.heartsmarterbook.com), is a practicing cardiologist and senior vice president for Northwell Health’s Katz Institute for Women’s Health, which focuses on the elimination of healthcare disparities through comprehensive clinical programs, gender-based research, community partnerships, and education. Rosen also is a professor of cardiology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and is a national spokesperson for the American Heart Association’s Go Red for Women movement.

Editor’s Note: Please see their book review for Heart Smarter for Women: Six Weeks to a Healthier Heart on pg. 11.