Keeping your heart operating like a well-oiled machine pumping oxygen and nutrient-rich blood throughout your body hinges on smart lifestyle choices.
"Just by doing the things we need to do can have a great impact," says Winston Gandy, a cardiologist with Piedmont Heart Institute.
That includes not smoking, eating a diet low in fat and cholesterol and getting regular exercise.
The amount and location of weight are important factors, too.
Disproportionate weight around the midsection increases the risk for diabetes and heart disease. "We see a lot of thin women who don't exercise or eat healthy, and those women are at higher risk of heart disease, too," says Gina Lundberg, fellow cardiologist and director of the Heart Center for Women at St. Joseph's Hospital.
Nearly all American women are in danger of heart disease or stroke and should be more aggressive about lowering their risk, according to the American Heart Association. Risk factors include obesity, stress, high blood pressure, high cholesterol and diabetes.
Minority women are particularly at risk for heart disease and stroke. Nearly half of African-American women have some form of cardiovascular disease, compared with 32 percent of white women.
If a woman develops even one of the risk factors at age 50, she greatly increases her chance of heart disease or stroke later.
Cigarette smoking, for instance, increases the risk of serious cardiovascular side effects from oral contraceptive use, and high blood pressure is two to three times more common in women taking oral contraceptives.
"Women are at greater risk and they are undertreated," says Lundberg, referring to how women are less likely than men to receive certain diagnostic testing and treatments, such as angioplasties and stents, for cardiovascular diseases.
One of the most important things everyone can do is have an annual physical exam that includes an exercise stress test to examine how well the heart works during physical exertion. Women older than 50 and men older than 40 should make an exercise stress test a part of their annual physical exam.
"An EKG is not good enough," says Gandy, referring to the test that records the heart's electrical activity. "It's like planning an outdoor wedding in three weeks and looking out the window today. It doesn't forecast anything."
Although the heart is very resilient, detecting coronary artery disease or blockage before a heart attack or cardiac arrest increases the survival rate.
"If we find it before it finds you, 99.9 percent of people come out as good as new," says Gandy.
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READINGS TO KNOW
> Total cholesterol: Less than 200 mg/dL
> LDL ("bad") cholesterol:
People who are at low risk for heart disease: Less than 160 mg/dL
People at intermediate risk for heart disease: Less than 130 mg/dL
People at high risk for heart disease, including those who have heart disease or diabetes: Less than 100 mg/dL
People at very high risk for heart disease: Less than 70 mg/dL
> HDL ("good") cholesterol: Women: 50 mg/dL or higher; men: 40 mg/dL or higher
> Triglycerides: Less than 150 mg/dL
> Blood pressure: Less than 120/80 mmHg
> Fasting glucose: Less than 100 mg/dL
> Body mass index: Less than 25 kg/m
> Waist circumference: Women: 35 inches or less; men: 40 inches or less (around the belly button, not pant size)
> Physical activity: At least 30 minutes of vigorous aerobic activity at least three days a week and strength/endurance activity at least two days a week.
Source: American Heart Association
BY THE NUMBERS
100,000: Daily heartbeats
5 quarts: of blood are pumped each minute
2,000 gallons: of blood are pumped each day
325,000: people a year die of coronary heart disease without being hospitalized or admitted to an emergency room
50 to 99: times a minute is how often a normal heart beats at rest
Source: American Heart Association
Copyright 2008 The Atlanta Journal-Constitution