What’s the most common cause of death among American women? Breast cancer? Accidents? Suicide after watching too many Lifetime Channel specials? Nope. Heart attacks kill more women than any other cause—same as men. A generation ago heart disease was mistakenly thought of as an exclusively male disease, but patients and physicians have learned that preventing and treating heart disease is critical in women too.
This week the American Heart Association published their updated recommendations for the prevention of cardiovascular disease in women in their journal Circulation. The good news is that the age-adjusted incidence of heart disease in women has been declining for some time as treatments for diabetes, high blood pressure, and high cholesterol have improved. The bad news is that our aging population and the increasing prevalence of obesity and diabetes suggest a possible increase of women’s heart disease on the horizon.
The updated parts of the recommendations alert physicians to cardiovascular risks that have been previously unappreciated. Complications of pregnancy, including gestational diabetes and preeclampsia, increase the subsequent risk of cardiovascular disease. Autoimmune disease such as lupus and rheumatoid arthritis are also associated with increased cardiovascular risk.
The recommendations also feature an important reminder about interventions that do not prevent heart disease in women. Unfortunately some of these treatments have become so popular through misinformation that a reminder that they don’t prevent stroke or heart attack is useful.
- Estrogen replacement therapy does not prevent stroke or heart attack.
- Antioxidant vitamin supplements (vitamin E, C, and beta carotene) do not prevent stroke or heart attack.
- Folic acid, vitamin B6 and vitamin B12 do not prevent stroke or heart attack.
The most valuable part of the recommendations is not new. These recommendations have been known and stressed for years but they deserve repetition because they are the most effective means of cardiovascular disease prevention. (Follow the link below to the Circulation article if you want much more detail about each recommendation.)
- Women should avoid smoking.
- Women should exercise regularly.
- Women should eat a diet rich in fruits, vegetables and whole grains, eat fish at least twice a week, and limit intake of saturated fat, alcohol and sugar.
- Women should maintain a normal weight.
- Women should maintain normal blood pressure through the above lifestyle modifications or through medications.
- Women should maintain normal cholesterol levels through the above lifestyle modifications or through medications.
- Women should maintain normal blood sugar levels through the above lifestyle modifications or through medications.
Of course, these same recommendations also apply to men.
Los Angeles Times Booster Shot: New heart health guidelines for women
Bloomberg Businessweek article: Experts Issue New Heart Disease Guidelines for Women