How to Prevent a Heart Attack

A Thorough Medical and Family History

Your first step in a prevention program is figuring out if you're in good health or whether changes are in order. You can know this for sure by getting a thorough evaluation from your internist or family physician. The risk profile she arrives at will show whether you need to change your habits, use medication, or be referred to a cardiologist. "The tests your doctor gives you, and the treatment plans she devises, will be based on your individual risk factors," says Lori Mosca, MD, director of preventive cardiology at New York-Presbyterian Columbia University Hospital.

When you make your appointment, tell your doctor you want a thorough heart checkup so she'll leave enough time to inventory your habits, do tests, take a family history, and review your current health. Schedule the visit early in the morning -- blood tests are more accurate if you haven't eaten for 10 to 12 hours. Be sure your exam includes the following six elements:

Your doctor should take a detailed medical and family history: If your mother or sister developed heart disease before the age of 65 or your father or brother did before 55, that increases the odds that you will, too. Having had a hysterectomy or having gone through menopause before age 45 also are risk factors. Diabetes -- whether you or a close relative has it -- is another huge red flag. "A diabetic woman has the same heart-attack risk [2.5 times that of a healthy person] as someone who's already had a heart attack," says Nanette K. Wenger, MD, chief of cardiology at Grady Memorial Hospital, in Atlanta. Ills such as the hormone disorder polycystic ovary syndrome and peripheral vascular disease (the narrowing of blood vessels) are also associated with heart disease.

Be honest about your lifestyle. "Don't be embarrassed to answer questions truthfully," says Nieca Goldberg, MD, chief of Women's Cardiac Care at Lenox Hill Hospital, in New York City, and author of Women Are Not Small Men: Life-Saving Strategies for Preventing and Healing Heart Disease in Women.

• Do you -- or did you ever -- smoke? Even one to four cigarettes a day make a woman almost five times as likely to die of heart disease. If you stopped 15 years ago, your risk is the same as a nonsmoker's. Just one year of being smoke-free halves your risk.
• How often do you exercise? Being sedentary is comparable to smoking or having high cholesterol as a risk factor because it contributes to the development of both high blood pressure and diabetes and allows artery-clogging plaque to form in blood vessels.
• How healthy is your diet? Foods that are loaded with high-glycemic carbs and saturated fats up heart-disease risk.
• Are you constantly frazzled? This prompts the release of hormones that can cause inflammation, another heart-risk factor.