Women and Heart Disease

Prevention

The American Heart Association recently published specific guidelines for preventing and treating coronary artery disease in women. These guidelines address lifestyle changes, medications and supplements, and hormone therapy in menopausal women. Ask your doctor which recommendations are appropriate for you.

Lifestyle changes

• Stop smoking, and avoid secondhand smoke.
• Do at least 30 minutes of moderate-intensity activity, such as brisk walking, on most days of the week.
• Eat a heart-healthy diet and limit saturated fat to less than 10 percent of calories, cholesterol intake to less than 300 mg, and avoid trans fats.
• Keep your body mass index (BMI) between 18.5 and 24.9 and your waist circumference less than 35 inches. To determine your BMI, click here and click on Body Mass Index.
• If you have coronary artery disease, be evaluated for depression.
• If you drink, do so in moderation (an average of one drink per day for women). If you do not drink, don't start.
• Adopt the DASH (Dietary Approaches to Stop Hypertension) eating plan, and reduce daily salt intake if you have high blood pressure.

Medications

• When high blood pressure (140/90 mm Hg or higher) cannot be controlled with lifestyle approaches, consider medications to control it.
• Lipid-lowering medication (usually statins) and lifestyle changes are recommended for women at intermediate to high risk of coronary artery disease.
• Women with diabetes should keep their hemoglobin A1c (HbA1c) level at less than 7 percent. HbA1c is a blood test that measures of how well blood sugar levels have remained within a safe range over the previous two to three months.
• Daily, low-dose aspirin is recommended for most women who are at intermediate to high risk of coronary artery disease. The routine use of low-dose aspirin in women at low risk of coronary artery disease is not recommended.
• Beta-blocker medications, which slow heart rate and reduce the workload on the heart, are recommended for women who have had a heart attack or those who have chronic chest pain (angina).
• Angiotensin-converting enzyme (ACE) inhibitor medications, which lower blood pressure and reduce the workload on the heart, should be used by most women at high risk for coronary artery disease.
• Angiotensin II receptor blocker (ARB) medications, which also lower blood pressure and reduce the workload on the heart, should be used by high-risk women with heart failure who cannot take ACE inhibitors.

Hormone therapy

Combined estrogen plus progestin (HRT) or estrogen-only hormone therapy (ERT) should not be taken solely to prevent coronary artery disease in postmenopausal women. Although hormone therapy is not recommended for coronary artery disease prevention, some women may take it for relief from menopausal symptoms. Most doctors recommend that you carefully weigh the benefits against the risks of taking hormone therapy before considering it.