Though popularly considered a men’s issue, heart disease is also the number-one cause of death for women in the US. Women typically develop heart disease symptoms about a decade later than men, but the underlying factors can materialize as early as their 20s.
“Heart disease grows very slowly and very quietly. The risk factors are also asymptomatic,” says Christina Adams, MD, Scripps Clinic integrative cardiologist. “Eighty percent of heart disease is preventable. We don’t want to frighten women; we want to empower them.”
Here are lifestyle changes you can make — and risk factors to keep an eye on — through each decade of life.
This is prime time to make lifestyle changes that can stave off heart disease in the future, says Dr. Adams. Avoid smoking and vaping, get regular exercise and switch to a mostly plant-based diet that limits processed foods.
You should also get control over noncardiac conditions that can increase your risk of heart disease, such as migraines, lupus, polycystic ovary syndrome and rheumatoid arthritis, and ask your doctor to monitor your cholesterol and blood pressure. Pay attention during pregnancy, too.
“We call pregnancy a woman’s first stress test,” Dr. Adams says. Preeclampsia and gestational diabetes can increase a woman’s risk of heart disease.
Balancing career and family can be tough, and self-care tends to fall by the wayside. The number on the scale starts to creep up and it seems like you’re getting less sleep than ever.
“We’re so distracted by all these life stressors,” says Dr. Adams, who advises women to “check in with yourself.”
Get your team on board — partner, family, coworkers, friends — and make your health a priority. Create a routine and stick to it, even if that means setting your phone to “do not disturb” and walking for 10 minutes at lunch. Practice good sleep hygiene, too, and be wary of sleep apnea, another risk factor.
In your 50s, cardiovascular risk factors start to catch up and become symptomatic.
“Heart disease is typically quiet — until it’s severe,” says Dr. Adams.
During menopause, LDL cholesterol increases and bone density and muscle mass decrease. During your 50s and 60s, it’s important to have an accurate assessment of your risk and know your numbers. Doctors may also recommend CT coronary-angio testing, which may indicate that medication is necessary. This is when high blood pressure, aka “the silent killer,” really tends to manifest.
“Untreated high blood pressure is the number-one reason women go into heart failure,” Dr. Adams adds.
Unfortunately, by this point most women have developed high blood pressure. The right medications are key to keeping blood pressure under control.
“At any age, the lower the blood pressure, the better,” says Dr. Adams.
Work with your physician to ensure your medications are well-tolerated with minimal side effects and consider a cardiac rehab program or physical therapy if you’ve already had a cardiac event.
Keep up the good work. Continue to get regular assessments, manage medication, eat healthy and stay as active as possible. Regular exercise can not only help prevent cardiac events, but also reduce the risk of falls, Alzheimer’s disease and dementia.
Ironically, Dr. Adams says, “the benefit of prevention is that nothing happens. I tell my patients, ‘We’ll celebrate when you’re 90, and nothing has happened.’”