How to Prevent a Heart Attack

A Frank Discussion About Symptoms

Tell your doctor if you're having any symptoms that make you feel less than healthy, even if you think they're not related to your heart. You don't have to feel as though an elephant is sitting on your chest to be having a heart attack.

Women's early warning signs of heart attack -- they may appear without resulting in an attack -- are often subtler than men's: unusual fatigue; back pain; shortness of breath; severe heartburn or stomach pain; sweating or flulike ills, such as nausea, clamminess, or cold sweats; pain or numbness in one or both arms, the shoulders or jaw; sleep disturbance; or heart palpitations. Repeated bouts could be a warning sign that your arteries have dangerously narrowed or that you have a severe blockage. "Even shortness of breath when you're stressed-out or angry shouldn't be ignored," says Jennifer Mieres, MD, assistant professor of medicine at New York University School of Medicine. These can be signs of an actual heart attack or angina (reduced blood flow to the heart). You may even have chest pain, the "male" symptom.

During a routine exam, your physician will take your blood pressure (anything higher than 120/80 is considered risky). She should also weigh and measure you to calculate your body mass index (BMI), a ratio of weight and height that shouldn't be higher than 24.9. Even being moderately overweight -- with a BMI between 25 to 29.9 -- nearly doubles your risk of heart disease; a BMI greater than 30 triples your odds. Why? Carrying extra pounds ups the risk of both high blood pressure (although thin people can suffer from hypertension, too) and diabetes and elevates bad cholesterol (LDL), all of which are major contributors to heart disease. (To calculate your BMI yourself, go to www.lhj.com/bmi.)

Your doctor should also measure your waist and calculate your waist-to-hip ratio. A new study of 27,000 people in 52 countries found that the waist-to-hip ratio (your waist measurement divided by your hip measurement) is an even better predictor of heart at-tack than BMI. A higher risk ratio for women is 0.8 or higher.

A waistline of 35 inches or more is another red flag, regardless of BMI. Apple-shaped women -- those who collect fat around their middles -- are more prone to heart disease because they are likelier to be suffering from metabolic syndrome, which triples the risk of death from heart disease according to a 2004 study. This condition occurs when cells are resistant to insulin, a hormone that helps the body convert sugar into energy (other risk factors for insulin resistance are triglycerides above 150 mg/dL, blood pressure at 130/85 or above, and HDL cholesterol levels below 50 mg/dL).