Today is Go Red for Women Day; it’s purpose is to raise awareness of the risks of heart disease, the number one killer of women over the age of 25.
We decided to ask an expert, Dr. Richard Stein, for advice on what women can do to ensure heart health. Dr. Stein is a Professor of Medicine and Cardiology at the New York University School of Medicine. He’s also the Director of the Exercise, Nutrition, and Cardiovascular Disease Program at the NYU Center for the Prevention of Cardiovascular Disease. He is the author of Outliving Heart Disease.
Here are Dr. Stein’s answers to our questions about heart health for women.
Lucille Roberts: What are the most important lifestyle choices women can make to keep their hearts healthy?
Dr. Richard Stein: The most important two things are 1) to do a self-inventory of your coronary heart disease risk factor, and 2) to see a doctor to learn your blood pressure, your lipid (cholesterol) levels, and your fasting blood sugar, and, if necessary, to start lifestyle modifications or treatment for these things.
Essential lifestyle factors include not smoking, getting moderate exercise for at least ½ hour most days of the week or vigorous exercise for more than 45 minutes at least 3 times a week, and eating a diet rich in vegetables and fruits and low in saturated fats. However, focusing only on healthy lifestyle factors would be a mistake because high blood pressure, abnormal cholesterol levels, and diabetes are BIG factors in treating, avoiding, and outliving heart disease.
LR: How is the heart affected by body weight?
RS: Increased body fat, noted in almost all people who are overweight, is associated with abnormal lipids—sometimes referred to under the title “cholesterols”—especially triglycerides and a low HDL. (High HDL is better: over 40 for men and over 50 for women are good guideline numbers.) Increased body fat is also associated with increased blood pressure and increased risk of diabetes.
Body weight for height is best evaluated as your BMI; this is your weight in kilograms divided by your height in meters squared. An easy way to determine your BMI is to type “BMI” into a search engine online, choose a free calculator, and enter you weight and height. A BMI below 19-25 is a good range; above this, you progress from overweight to obese to significantly obese. With extreme obesity, there is evidence of infiltration of the heart muscles with fat, and this can lead to sudden, severe heart problems.
LR: Is it possible for a thin person to have an unhealthy heart? How would someone know whether she’s at risk for cardio problems if she’s not overweight?
RS: Yes. Being thin but inactive, smoking, and having high blood pressure will raise your risk of being a thin person with heart disease.
RS: My best advice to moms (and dads) is to live heart-healthy lives yourselves with a good diet, active lifestyle, and periodic medical exams. Teach by example!
LR: Any specific tips for pregnant women–both for their own cardio health and for their baby’s heart?
RS: Yes: not smoking. Also, ask your doctor to check your blood pressure and the proteins in your urine to detect preeclampsia (hypertension during pregnancy) and to check your urine and blood sugar to detect gestational diabetes. Make sure to check any new medication prescribed during pregnancy with your obstetrician to make sure it is safe for the baby.
LR: In your experience, what is the most common misconception about heart health?
RS: That if you do one thing very well, you won’t get heart disease. For example, “I exercise every day”; “I eat a vegetarian diet”; “I see my doctor twice a year”; “I don’t smoke”. In fact, heart disease, most often in the form of atherosclerosis of the heart’s arteries, is the most common cause of death in women over 45 years of age. Heart disease in women is relatively lower than in men until women reach menopause, at which point the rate for women starts to catch up with men’s. But smoking or having diabetes essentially wipes out this “gender protection”.
LR: Anything else you’d like to add?
RS: The book I wrote, Outliving Heart Disease, goes into all of this in more detail. It is just becoming outdated in respect to certain tests and advanced treatment of cardiac arrhythmias, but otherwise it is sound. Also, the best diet book, the DASH diet, is free. It can be downloaded online.