The road to women’s heart health is paved with knowledge. With heart disease being the leading cause of death for women in the United States, understanding risk factors and methods to prevent heart disease and maintain heart health are both crucial and likely easier than most people may think.

Risk factors for heart disease

According to Tina Varghese, M.D., a cardiologist with Piedmont Heart of Buckhead, risk factors for heart disease that affect both women and men include high blood pressure, high cholesterol, diabetes, smoking and a family history of early heart disease. However, women should also be aware of additional risk factors, such as:

• Pre-eclampsia
• Gestational diabetes
• Polycystic ovary syndrome

“Heart disease risk also increases for women during and after menopause due to a decrease in estrogen levels, increase in cholesterol levels and changes in body composition,” Dr. Varghese adds.

Preventing heart disease in women

Dr. Varghese states there can be a perception that heart disease is a man’s illness. “This is simply not true,” she explains. “Heart disease is the number one cause of death in women in the United States, and women often have worse outcomes than men after a heart attack.”

Prevention consists of two main steps, Dr. Varghese says.

Step one: Realizing we have the power to change the current statistics.

Step two: Being proactive with our health and not reactive. She encourages people to “know your risk factors and your medical history, work with your doctor to treat any uncontrolled conditions and create a lifestyle that promotes heart health.”

Keeping your heart healthy

To maintain a healthy heart, Dr. Varghese says to think “SMART.”

1. Practice the three S’s: Sleep More, Stress Less, and Don’t Smoke

• Have a nightly routine that minimizes electronics and allows time for winding down. Get to bed around the same time every night, and aim for at least seven hours of sleep. Having adequate and good quality sleep not only helps you feel refreshed in the morning but also helps reduce your risk of developing heart disease. If you snore, consider getting tested for sleep apnea, another cardiovascular risk factor.
• When life gets busy juggling work and home responsibilities, stress can become a persistent presence. Incorporate helpful ways of relaxation, such as outdoor walks, meditation, journaling, yoga, a relaxing hobby or social gatherings with friends and loved ones.

If you don’t smoke, don’t start. If you do smoke, work with your doctor to get assistance with quitting.

2. Movement Matters

150 minutes of physical activity is recommended weekly, but even short bursts of movement throughout the day can be beneficial. For example, you can set a timer at work every hour to get up and move, walk during phone calls and park farther away from your destination. Incorporate resistance training and dynamic stretches to your exercise regimen to not only promote cardiovascular health but help reduce injury and maintain mobility with aging.

3. Limit Alcohol

Alcohol intake should be moderate or lower, meaning no more than one drink per day for women. Prior perceptions that mild alcohol consumption could be beneficial for one’s health are being met with an increasing notion that no amount of alcohol is advantageous.

4. Eat the Rainbow

Make sure your meal has different colored vegetables and fruits to increase the variety of nutrients you are getting. Eat a Mediterranean Diet, which should be viewed less as a diet and more as a lifestyle that incorporates consumption of vegetables, fruits, whole grains, olive oil, beans, nuts and seeds, and healthy fats. Limit foods with trans-fat, such as baked goods and fried foods.

5. Tackle it Together

Managing your heart health does not need to be an isolated endeavor. Create healthy meal plans with a family member, go to a gym class or on a hike with a friend, or take the stairs at work with a colleague. Accountability partners help people adhere to their goals longer and more consistently.

How heart disease differs between men and women

Risk factors: While women can have the typical risk factors for heart disease as men, they also experience unique conditions that should be factored into their heart disease risk profile, including pregnancy complications, early menopause and polycystic ovary syndrome, Dr. Varghese explains. “Women also more commonly experience certain autoimmune diseases (like lupus) and mental health conditions (like depression) that are linked to an increased risk of heart disease.”

Types of heart attacks: While a “heart attack” often implies a blockage in one of the main arteries of the heart, Dr. Varghese explains that women are more likely to have other forms of a heart attack, such as heart artery vasospasms, spontaneous coronary artery dissection and blockages in the very small heart arteries (known as microvascular dysfunction) that may not be seen by routine tests.

Symptoms: Women may not have the usual symptoms we’ve learned to associate with a heart attack, such as chest pain, Dr. Varghese warns. “Women may instead present with nausea, shortness of breath, jaw pain, indigestion or significant fatigue,” she says.

Heart health resources through Piedmont Heart

If a woman wants to understand her personal risk of developing heart disease, the Women’s Heart Screening Program at Piedmont is an excellent place to start,” Dr. Varghese says. “The screening includes a complete medical history, physical exam, electrocardiogram, ankle-brachial index and blood work. A customized heart health report and next steps are provided.” If necessary, a referral to one of Piedmont’s cardiologists can also be placed for continued management of risk factors.

In addition, the Piedmont Women’s Heart Program provides women at risk of or with heart disease a supportive network to connect with others and access resources, including instructive classes and wellness coaching, free of charge.

Progress in awareness for women and heart disease

Recently, campaigns have made progress in improving awareness about heart disease in women, and women are being increasingly represented in research trials – good news according to Dr. Varghese.

“Fortunately, many heart attacks and other forms of heart disease are preventable through education, lifestyle modifications and medications when appropriate,” Dr. Varghese says. “Playing an active role in one’s health can drastically change the trajectory of one’s wellbeing and promote a more fulfilling and enriching life experience.”

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