Susan M. Kleiner, PhD, RD, FACN, CNS, FISSN
Heart Disease accounts for the deaths of 1 out of every 3 women. It is considered nearly epidemic. For years the symptoms and risks of heart disease in women were ignored. This week the American Heart Association published the most comprehensive guidelines yet for preventing heart disease in women. The focus has changed to a woman’s lifetime risk for heart disease, rather than the short-term risk that was the focus of the 2004 guidelines.
According to Dr. Lori Mosca, chair of the American Heart Association’s (AHA) expert panel that devised the guidelines, “Cardiovascular disease is the leading cause of death among women. The rate of awareness among women has increased from 30 to almost 60 percent, but we still need to work on the confusion around preventive strategies. We are very encouraged that the release of these new guidelines can help clear up some of this confusion and help our women engage in more conversations with physicians and health care providers as to what are the best strategies to reduce the burden of the number-one killer of women.”
The new guidelines include expanded recommendations on lifestyle factors such as physical activity, nutrition and smoking cessation, as well as more in-depth recommendations on drug treatments for blood pressure and cholesterol control that you can pursue with your health care provider.
Highlights of the changes include:
Help manage blood pressure by controlling weight, increasing physical activity, moderating alcohol intake, restricting sodium intake, and especially eating fresh fruits, vegetables and low-fat dairy products.
Quit smoking. If you need to quit, the 2007 guidelines recommend counseling, nicotine replacement or other forms of smoking cessation therapy.
If you need to lose weight or sustain weight-loss, exercise. Include at least 60 to 90 minutes of moderate-intensity activity on most, and preferably all, days of the week. Brisk walking is a good, moderate-intensity activity.
All women should reduce their intake of saturated fats to less than 7 percent of calories, if possible. (See the Chapter Notes for Chapter 1 in The Good Mood Diet for more information on saturated fats.)
Eat oily fish at least twice a week and consider taking supplements as follows:
- Women with heart disease should consider taking a capsule supplement of 850 to 1000 mg of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).
- Women with high triglycerides should take a capsule supplement of 2 to 4 grams of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).
Not recommended to prevent heart disease:
- Hormone replacement therapy and selective estrogen receptor modulators (SERMs) are not recommended to prevent heart disease in women.
- Antioxidant supplements (such as vitamins E and C and beta-carotene) should not be used for primary or secondary prevention of cardiovascular disease.
- Folic acid should not be used to prevent cardiovascular disease. This is a change from the 2004 guidelines that did recommend it be considered for use in certain high-risk women.
Aspirin therapy may be considered as follows:
- For women age 65 or older, regardless of their risk for cardiovascular disease, routine low-dose aspirin therapy may be considered, if the benefits are likely to outweigh other risks. (Previous guidelines did not recommend aspirin in lower-risk or healthy women.)
- For women with a very high-risk for heart disease, consider reducing LDL cholesterol to less than 70 mg/dL. (This may require a combination of cholesterol-lowering drugs.)
All women should take these guidelines very seriously. If you are in a room with 2 other women, the odds are that one of you will die of heart disease. Make the choice to change that statistic today.