Though most women develop heart disease after menopause, it appears to be growing faster than ever among younger women. Each decade of life brings its own challenges -- and opportunities to improve your heart health for decades to come.
In Your 30s
"A lot of women look in the mirror and say, 'I can fit into my skinny jeans, so I must be healthy,'" says Emily G. Kurtz, MD, director of Preventive Cardiology at Vanderbilt University Medical Center in Nashville. But studies find that plaque buildup in blood vessels can begin as early as your 20s, and with heart attacks in younger women on the rise, the 30s is the time to think ahead and set healthy patterns, like exercise and a heart-healthy diet, that will pay dividends throughout your life.
- Eat less junk. "Young working women go for quick and cheap food, but its impact on your weight and waistline correlates closely to your heart risks," says Holly Andersen, MD, director of education at the Ronald O. Perelman Heart Institute at New York-Presbyterian Hospital.
- Know your numbers. If you haven't gotten readings of your cholesterol, blood sugar, and blood pressure, see your doctor for a baseline exam.
- Avoid birth control pills if you smoke or have high blood pressure. The combination has been shown to increase your risk of developing blood clots and having a heart attack, especially in pills containing the progestin drospirenone.
- Get more shut-eye. "Don't underestimate the impact that sleep deprivation has on your weight and cardiovascular health," Dr. Andersen says.
- Breastfeed if you can. Women who do so are less likely to develop plaque buildup in their coronary arteries, according to a recent study.
In Your 40s
You'll gain weight more easily as your metabolism slows, and many women feel double-whammy stress from raising a family and caring for aging parents. "Depression, which is a significant risk factor for cardiovascular disease, is more likely, too," says Dr. Andersen. "Maintaining your mental and physical health now will make it easier to deal with age-related changes around the corner."
- Exercise regularly. It will improve your mood along with other cardiovascular risk factors. If lifestyle changes don't banish the blues, consider therapy or antidepressants.
- Make yourself a priority. It's vital to carve out time for stress-relieving activities like meditation, reading, and socializing with friends.
- Pay even more attention to your diet. Eat lots of fruits, vegetables, whole grains, and fish, and keep intake of saturated fat, salt, alcohol, and calories low.
In Your 50s
As you go through menopause, protective estrogen levels drop, bad cholesterol levels typically rise while good cholesterol levels fall, and blood vessels become less elastic. Fat begins to accumulate more in your gut than on your hips. All of these are warning signs.
- Review the major risks. Talk with your doctor about family and pregnancy history, high cholesterol, hypertension, obesity, and physical activity. Having just one major factor substantially increases the danger, Dr. Kurtz says. If you've been diagnosed with diabetes, peripheral artery disease, or chronic kidney disease, or have a known heart condition, your chances of a heart attack go up even more.
- Think twice about hormones. Carefully weigh the pros and cons of hormone therapy for menopause symptoms with your doctor. HT is not recommended by the American Heart Association, but recent research suggests some formulations may be less risky to the heart, especially when taken in low doses early in menopause or in perimenopause. "We no longer view HT as all or nothing but in shades of gray," says Claire Duvernoy, MD, founder of the Women's Heart Program at the University of Michigan Health System.
- Lift some weights. Make strength training part of your exercise routine. You lose muscle with age, but women who work out retain some forms of strength better than men.
- Consider meds. Talk to your doctor about taking aspirin or statins if you're at risk.
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