Health Topics

Midlife Women: 7 Steps to Your Healthiest Heart

Risk of Heart Disease Increases as you Age

Heart disease, the No. 1 killer of American women, isn’t “one size fits all.” Symptoms can differ from one woman to the next — heart palpitations and dizziness in one, shortness of breath and fatigue in another, swollen legs and ankles in someone else.

But one thing is true for every woman: “Risk of heart disease increases as you age. And it skyrockets after menopause, when your ovaries stop making the heart-friendly hormone estrogen,” says Andrea Sikon, MD, of Cleveland Clinic’s Center for Specialized Women’s Health.

Estrogen helps regulate cholesterol, keep blood vessels healthy and prevent plaque buildup, among other things. No surprise that women are more likely to have a heart attack about 10 years after menopause, according to the American Heart Association.

If you are approaching menopause or are well into postmenopause, be certain your ticker is working its best.

Seven Steps To Your Healthiest Heart

Step 1. Exercise throughout the week.

Your heart is like any other muscle — it needs a workout to stay strong. At the very least, do moderate exercise for 30 minutes a day on most days. Walking, dancing, swimming, jogging, and even doing yard work or housework are good options. Any physical activity improves how easily your heart pumps blood through your body.

Step 2. Eat a heart-healthy diet.

Heart disease is sometimes caused by buildup of plaque, a waxy substance in your blood vessels. While not all plaque comes from what you eat, some may be linked to a high-fat diet.

So, limit saturated fats and cholesterol, and stay away from all trans fats. They’re most often found in processed foods such as:

  • Potato chips
  • Cakes
  • Cookies
  • French fries
  • Doughnuts

Omega-3 fatty acids are good fats. Go ahead and eat those — in foods including tuna, salmon, flaxseed, almonds and walnuts. Polyunsaturated and monounsaturated fats also are good for you and are found in fish, nuts and vegetable oils.

Enjoy plenty of fruits, vegetables, legumes (e.g., beans and peas) and whole grains. Fat-free or low-fat dairy, skinless poultry and lean meats are also healthy options.

Hold back on salt and sweets. Too much sodium can cause high blood pressure (see Step 5). Too much added sugar can cause type 2 diabetes (see Step 6).

Step 3. Work toward a “normal” weight.

The more you weigh, the harder your heart has to work to give your body nutrients.

How do you know if you weigh too much? Calculate your body mass index (BMI), a measure of body fat based on your height and weight. If you fall within the “overweight” or “obese” ranges, take steps to work toward the “normal” range.

Your key to weight loss: “Burn more calories than you consume,” says Dr. Sikon. “There really is no other way. Tricking your body with other weight-loss schemes won’t work long-term.”

Step 4. Keep your total cholesterol level below 200 mg/dL.

In addition, keep your:

  • “Good” HDL cholesterol above 60 mg/dL
  • “Bad” LDL cholesterol below 100 mg/dL
  • Triglycerides below 100 mg/dL

Too much “bad” LDL cholesterol can build up in your blood vessels as plaque, which increases your risk for heart attack or stroke.

See your doctor for a blood test to measure your cholesterol levels. If your scores aren’t in the optimal ranges, work to improve them with a healthy diet and exercise and by not smoking.

Step 5. Keep blood pressure at or below 115/75.

If your blood pressure is higher than this optimal range for women, your blood may be pushing too hard on your arteries. Over time, that could weaken your blood vessels and make your heart pump harder to get blood through them.

Blood pressure often increases as you age. But you can temper it with lifestyle choices, such as a heart-healthy diet and physical activity.

Step 6. Control blood sugar.

And thereby reduce your risk of diabetes.

“If you’re a woman with diabetes, your risk of heart disease is as great as if you already had heart disease,” says Dr. Sikon.

See your doctor for a blood test to determine your blood sugar level. Scoring varies by type of test. If your blood sugar is too high, take steps to lower it by:

  1. Losing weight
  2. Eating healthier
  3. Exercising more

Step 7. Avoid tobacco.

Smokers have more than twice the risk of a heart attack than nonsmokers. Even smoking one to two cigarettes a day — or being around secondhand smoke continuously — greatly increases your risk of heart attack, stroke and other cardiovascular conditions. Get away from tobacco.

“All seven steps work together to keep your heart beating its best,” says Dr. Sikon. “But achieving just one or two is still beneficial. Many steps are interrelated."

While age and genetics also play a role in heart disease, a healthy lifestyle goes a long way to keeping your ticker strong at midlife and beyond.