When you're a mom of tweens or teens, days can go by in which your chief form of exercise is shifting your right foot from the gas pedal to the brake. Even if you're not constantly carpooling, it can be hard to fit in workouts between your job, caring for aging parents, and checking in with your husband once in a while. But exercise is particularly important in these years: It works to counteract the slowdown of your metabolism, which tends to start in your 40s, and it helps you avoid weight gain. (Related: The Best Diet to Boost Metabolism)
Alas, working out won't necessarily lead to a dramatic drop in pounds, but research suggests it's key for holding the line - and that may be enough to protect your heart. A study at the University of North Carolina at Chapel Hill found that overweight adults who maintained their weight, gaining no more than five pounds over 15 years, were less likely to have unhealthy changes in their glucose, cholesterol, and blood pressure than those who put on more. (Related: How to Lose the Weight for Good)
You may have great intentions, but if you're like 78 percent of women, you're not quite fulfilling them. Best trick: Find a routine that you like and that fits into your day. For inspiration, go to goredforwomen.org and click on BetterU, a free 12-week program you can personalize.
Do you need special screening tests? More and more doctors are turning to cool, high-tech scans to identify new risk markers for heart disease. But a recent analysis from the U.S. Preventive Services Task Force concluded that there is little proof that these improve your treatment. What's more, some tests are potentially harmful: For instance, electron beam computed tomography (EBCT) - a scan that identifies calcium deposits in your arteries - exposes you to radiation equivalent to 10 chest X-rays. "In general, women should skip these tests until there's more evidence they're beneficial," cautions Lori Mosca, M.D., a preventive cardiologist at New York-Presbyterian Hospital in New York City. But that doesn't mean you don't need any tests, especially if you're at high risk. A stress echocardiogram or a nuclear imaging stress test, which are both done as you walk on a treadmill, can provide key warnings about your heart's health.
And doctors for all women should be doing a "global risk estimation" every five years. Basically, this is a mathematical formula used to calculate your odds of having a heart attack in the next 10 years, based on such factors as your age, blood pressure, cholesterol levels, whether you have diabetes, and other risks. Your doctor may or may not share the actual number with you (you can ask), but the information helps her make decisions about the best care for you.Surprising Hidden Risks
• Hysterectomy. Until recently, women who were having this surgery because of problems like uterine fibroids often chose to have their ovaries taken out along with their uterus, as protection against ovarian cancer. But now there's good reason to rethink that decision: A recent study of almost 30,000 women found that those who had both ovaries removed before age 50 and who never used estrogen therapy had up to a 98 percent higher risk of heart disease than those who kept them. Ovaries continue to make small amounts of hormones for years after natural menopause, guarding against heart disease as well as stroke.
But what about ovarian cancer? "The heart protection far outweighs the less than 1 percent lifetime risk of ovarian cancer," notes lead author William H. Parker, M.D., of the John Wayne Cancer Institute in Santa Monica, CA. The exception: If you have a relative - a mother, sister, grandmother, aunt, or cousin - who's had ovarian or breast cancer, especially before menopause, then it might make sense for you to have your ovaries out, says Dr. Parker. (Related: Alternatives to Hysterectomies)
• Breast calcifications. If your mammogram shows specks of calcium deposits in the arteries of your breast, you might not have to worry about cancer, but you do need to pay more attention to your cardiovascular health: You may have more than triple the risk of heart disease of a woman without these deposits, a recent University of Missouri School of Medicine study found. Don't count on your primary-care doc to alert you: Even if the calcifications are noted on the mammogram report (and they may not be), since they're not cancerous, your doctor may not mention them, says lead author Paul S. Dale, M.D. But you shouldn't miss out on this chance for lifesaving information. "Ask if vascular calcifications were noted, and if they were, ask if your heart health needs to be looked at differently," says Dr. Dale.
YOUR CHECKUP CHECKLIST
Start screening early - then don't slack off. These are the tests all women should have, says the American Heart Association, but ask your doctor about special exams or more frequent checks if you're at higher risk.
• Blood pressure, pulse, waist circumference, and BMI: Have these measured every two years
• Glucose: every three years starting at 45
• A "global risk estimation" - the score that indicates your odds of having a heart attack in the next 10 years. Repeat every five years
More Health & Fitness Advice from Good Housekeeping:
Discover Your Perfect Diet
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Test Your Calorie IQ
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