Get Smart
You know that your kid's unfinished fries and burger do not qualify as a heart-healthy diet. Ditto for birthday cake, cheese puffs (even if they're organic), and all the other fat-laden, artery-clogging fare you may encounter as a mom of young children. But your biggest heart hazard may be in your head, not on your plate. "Women in their 30s often think they're too young for heart disease, even though they've already developed serious risk factors," says Sarah Samaan, M.D., a cardiologist at Legacy Heart Center in Plano, TX. In fact, as many as 60 percent of women under 40 have at least one high-risk factor, such as smoking, elevated cholesterol, or obesity - which triples their heart attack odds. To lower those chances, you need to know where you stand. Almost 20 percent of women have never had a blood cholesterol test, although the American Heart Association recommends one at least every five years starting at age 20 (see "Your Checkup Checklist," below). You still have plenty of time to shape up before you hit the really high-risk years. Make an appointment with your doctor to review where you stand; then get serious about quitting smoking, losing weight, eating right, and exercising. (For how-tos, go to "Jump-Start a Healthy Heart".)
Do you need to reconsider the Pill?Yes - if you're over 35 and have high cholesterol, uncontrolled high blood pressure, or a BMI over 30, or you smoke. Oral contraceptives - especially older versions with high doses of estrogen - worsen these heart disease risk factors and increase the chance of blood clots. Newer, lower-dose Pills may be safer, though there aren't data yet to confirm this. But as long as you don't have any of those risk factors, "you can safely use the Pill until age 50 or until you reach menopause," says C. Noel Bairey Merz, M.D., director of the Women's Heart Center at Cedars-Sinai Medical Center in Los Angeles. (Related: Pros and Cons of Different Birth Control Methods)
Surprising Hidden Risks
• Missed periods. Just about everyone skips from time to time, but women with long histories of irregular cycles at age 35 have a 50 percent greater chance of eventually having a heart attack, a large Harvard study reported. It may be because erratic cycles are frequently linked with obesity. They're also a sign of polycystic ovary syndrome (PCOS), a common hormonal disorder that raises the risk of high cholesterol, high blood pressure, and diabetes, as well as infertility and acne. Medication and weight loss (if needed) can get symptoms under control - and should reduce your heart risk, says Anuja Dokras, M.D., an ob-gyn at the Hospital of the University of Pennsylvania. Still, to be on the safe side, she advises her PCOS patients to get cholesterol and blood sugar checks every other year. (Related: 5 Things You Didn't Know About Your Period)
• High blood sugar in pregnancy. You don't have to have had full-blown gestational diabetes - even the suspicion of the disorder is heart-risky. A University of Toronto study found that women who "fail" the glucose screening test that's routinely given in pregnancy have a 19 percent increased risk of heart disease over the next 12 years - even if they pass the second, definitive test and do not have the disease. (For women who do have it, odds jump by 66 percent.) This scenario - a positive screening and negative diagnostic test - may be an indication that a woman's glucose control and arteries aren't quite as healthy as they could be, says lead author Ravi Retnakaran, M.D. What can you do now? Ask your doctor about more targeted checkups for potential heart problems - and keep your weight down.
• Low vitamin D. In a large Finnish study, adults over age 30 who had the lowest blood levels of vitamin D were 25 percent more likely to die from cardiovascular disease later in life than those with the highest levels. "Vitamin D may keep the muscle cells that line the artery walls healthy and flexible, helping to maintain good blood flow to the heart and brain," says Michal Melamed, M.D., of Albert Einstein College of Medicine in New York City. Only 23 percent of Americans have adequate D levels; to find out where you stand, ask your doctor for a blood check. What's a "good" level? Experts aren't sure what number is ideal, but agree it should be at least 30 nanograms per milliliter. As for supplements, current guidelines recommend 200 IUs of D daily for people ages 19 to 50, 400 IUs for ages 51 to 70, and 600 IUs for those over 70, but most experts think 1,000 IUs is more in line with what you really need.
YOUR CHECKUP CHECKLISTStart 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
• Family history: Update at every doctor's visit
• Fasting cholesterol: Test every five years
More Health & Fitness Advice from Good Housekeeping:
Easy At-Home Work-Outs
30 Days to a Better Butt
Give Into Cravings Without Wrecking Your Diet
50 Calorie Snacks
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Reprinted with permission of Hearst Communications, Inc.
