The overlooked problem of heart disease

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Women, is your biggest health worry breast cancer? Think again. One out of three women die of heart disease. In fact, women's deaths from heart disease are greater than all cancers combined.

Most women are terrified of breast cancer, and this is understandable. But most women are not aware that 39 percent of U.S. women die from heart disease, compared to just 4 percent from breast cancer. Disease of the heart includes arrhythmias, congestive heart failure and coronary artery disease.

Heart disease crosses into both genders. The condition is more often fatal in women than in men. A woman has a 50 percent chance of dying from her first heart event, compared with a 30 percent chance for a man. Heart disease leaves 46 percent of women severely disabled by a stroke or congestive heart failure, compared to 25 percent of men.

Women don't usually start showing signs of heart disease until their 60s -- about 10 years after men first develop symptoms. Hormones seem to offer some protection before menopause. But last year the Women's Health Initiative revealed that pills providing a combination of estrogen and progestin do not protect the hearts of postmenopausal women. So, what seemed to have been a solution to the aging female heart -- replacing the hormones a woman makes before menopause -- has vanished.

If hormones don't protect women from developing heart disease, what does? The majority of heart attacks in women could be avoided by following a combination of lifestyle modifications and, in some cases, medication. Risk factors include elevated cholesterol levels, high blood pressure, insulin resistance and type 2 diabetes, obesity and lack of physical activity. Smoking more than triples a woman's chances of having a heart attack. Far more smokers die of cardiovascular disease than lung cancer.

Saturated fat increases total cholesterol levels and low-density lipoprotein (LDL, the "bad" cholesterol). Limit consumption of fatty red meats, butter, cream, whole milk and cheeses, as well as coconut, palm and palm-kernel oils. Instead, eat fruits, vegetables, whole grains and lean meats.

Consider adding cold-water fatty fish such as salmon, tuna, herring, sardines and mackerel. These are high in beneficial Omega 3 fatty acids. If you don't like fish, add ground flax seed to smoothies, cereal and yogurt.

Hypertension, or high blood pressure, makes the heart work harder to move blood through the body. To control your blood pressure, exercise on a regular basis, lose excess body fat, minimize alcohol intake, eat wholesome, low-fat foods and watch your salt intake.

Insulin resistance and type 2 diabetes raise the risk greatly. Insulin resistance is defined as the resistance to the blood-sugar-lowering action of insulin. It is often present for many years before blood sugar levels rise above normal. Insulin levels increase with weight gain.

Losing weight will lower your risk of cancer, diabetes and heart disease. Start keeping a food diary to track what you are eating and plan menus and meals ahead of time. Eat a variety of wholesome foods, and watch portion size.

Set goals for exercise. If you have been sedentary for a long time, see your physician before starting an exercise program and start slowly. Consider exercising with friends to keep you motivated and consistent. You may want to look for a personal trainer to evaluate your current fitness level and develop a program just for you.

Women can do plenty to help protect themselves from heart disease, their number one killer. While there are no guarantees, adopting a healthier lifestyle is key to prevention.

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