A woman's guide to a healthy heart

The road to women’s heart health is paved with knowledge. Heart disease is the leading cause of death for women in the United States. Understanding risk factors and prevention is crucial—and often easier than people think.

Risk factors for heart disease

According to Tina Varghese, M.D., a cardiologist with Piedmont Heart of Buckhead, risk factors for heart disease that affect both women and men include high blood pressure, high cholesterol, diabetes, smoking and a family history of early heart disease. However, women should also be aware of additional risk factors, such as:

• Pre-eclampsia
• Gestational diabetes
• Polycystic ovary syndrome

“Heart disease risk also increases for women during and after menopause due to a decrease in estrogen levels, increase in cholesterol levels and changes in body composition,” Dr. Varghese adds.

Preventing heart disease in women

Dr. Varghese states there can be a perception that heart disease is a man’s illness. “This is simply not true,” she explains. “Heart disease is the number one cause of death in women in the United States, and women often have worse outcomes than men after a heart attack.”

Prevention consists of two main steps, Dr. Varghese says.

Step one: Realizing we have the power to change the current statistics.

Step two: Being proactive with our health and not reactive. She encourages people to “know your risk factors and your medical history, work with your doctor to treat any uncontrolled conditions and create a lifestyle that promotes heart health.”

Keeping your heart healthy

To maintain a healthy heart, Dr. Varghese says to think “SMART.”

1. Practice the three S’s: Sleep More, Stress Less, and Don’t Smoke

• Have a nightly routine that minimizes electronics and allows time for winding down. Get to bed around the same time every night, and aim for at least seven hours of sleep. Quality sleep helps you feel refreshed and lowers your risk of heart disease. If you snore, consider getting tested for sleep apnea, another cardiovascular risk factor.
• When life gets busy juggling work and home responsibilities, stress can become a persistent presence. Incorporate relaxing activities like walks, meditation, journaling, yoga, hobbies, and time with loved ones.

If you don’t smoke, don’t start. If you do smoke, work with your doctor to get assistance with quitting.

2. Movement Matters

150 minutes of physical activity is recommended weekly, but even short bursts of movement throughout the day can be beneficial. Set hourly reminders to move, walk during calls, and park farther away. Add resistance training and dynamic stretching to support heart health, reduce injury risk, and maintain mobility as you age.

3. Limit Alcohol

Alcohol intake should be moderate or lower, meaning no more than one drink per day for women. Prior perceptions that mild alcohol consumption could be beneficial for one’s health are being met with an increasing notion that no amount of alcohol is advantageous.

4. Eat the Rainbow

Make sure your meal has different colored vegetables and fruits to increase the variety of nutrients you are getting. Adopt a Mediterranean-style lifestyle centered on foods like vegetables, fruits, whole grains, olive oil, beans, nuts, seeds and healthy fats. Limit foods with trans-fat, such as baked goods and fried foods.

5. Tackle it Together

Managing your heart health does not need to be an isolated endeavor. Plan healthy meals with family, stay active with friends, and choose simple movement like taking the stairs. Accountability partners help people adhere to their goals longer and more consistently.

How heart disease differs between men and women

Risk factors: Women face typical and unique heart risks, including pregnancy issues and menopause. “Women also more commonly experience certain autoimmune diseases (like lupus) and mental health conditions (like depression) that are linked to an increased risk of heart disease”, Dr. Varghese explains.

Types of heart attacks: While a “heart attack” often implies a blockage in one of the main arteries of the heart, Dr. Varghese explains that women are more likely to have other forms of a heart attack, such as heart artery vasospasms, spontaneous coronary artery dissection and blockages in the very small heart arteries (known as microvascular dysfunction) that may not be seen by routine tests.

Symptoms: Women may not have the usual symptoms we’ve learned to associate with a heart attack, such as chest pain, Dr. Varghese warns. “Women may instead present with nausea, shortness of breath, jaw pain, indigestion or significant fatigue,” she says.

Heart health resources through Piedmont Heart

If a woman wants to understand her personal risk of developing heart disease, the Women’s Heart Screening Program at Piedmont is an excellent place to start,” Dr. Varghese says. “The screening includes a complete medical history, physical exam, electrocardiogram, ankle-brachial index and blood work. A customized heart health report and next steps are provided.” If necessary, a referral to one of Piedmont’s cardiologists can also be placed for continued management of risk factors.

In addition, the Piedmont Women’s Heart Program provides women at risk of or with heart disease a supportive network to connect with others and access resources, including instructive classes and wellness coaching, free of charge.

Progress in awareness for women and heart disease

Recently, campaigns have made progress in improving awareness about heart disease in women, and women are being increasingly represented in research trials – good news according to Dr. Varghese.

“Fortunately, many heart attacks and other forms of heart disease are preventable through education, lifestyle modifications and medications when appropriate,” Dr. Varghese says. “Playing an active role in one’s health can drastically change the trajectory of one’s wellbeing and promote a more fulfilling and enriching life experience.”

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