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Cardiovascular disease is the leading killer of women in the United States, taking the lives of more than 500,000 women each year. That's more than the number of deaths in men and more than the next seven causes of death in women combined.

Risk Increases After Menopause

Risk Factors

In general, a woman's risk for cardiovascular disease increases around the time of menopause, which may be related to:

Higher Than Men

"Women in the U.S. actually have a higher prevalence of cardiovascular disease than do men, starting around age 65," says Dr. Loryn Feinberg, director of the  Women's Cardiovascular Health Program at Beth Israel Deaconess Medical Center. "They are also more likely to die of cardiac disease, which may be related to their older age at presentation."

Prevention Is Essential

No Previous Symptoms

Because cardiovascular disease is often fatal, and because nearly two thirds of women who die suddenly have no previously known symptoms, it is essential to prevent cardiovascular disease from developing in the first place.

"Fortunately, the development of cardiovascular disease is often due to the development of various conditions that can often be prevented or at least controlled through a host of lifestyle modifications and/or treatment with specific medications," says Dr. Feinberg.

Smoking Cessation Top Priority

The American Heart Association has outlined several such strategies to reduce the odds of developing CVD.  Smoking cessation as a top priority among a number of heart-healthy lifestyle changes, as over 40 percent of coronary events in women may be linked to smoking.

Diet and Exercise

Healthy Foods

Other important components of a heart-healthy lifestyle include regular participation in moderate-intensity physical activity, and eating a heart-healthy diet that favors a variety of fruits and vegetables, whole grainslow-saturated fat or non-fat dairy products, and regular consumption of fish, and low-saturated fat proteins such as nuts, legumes, poultry and lean meats.

Reduce Salt, Add Fish Oil

Dietary sodium restriction, which includes omitting or limiting processed food intake, is also believed to decrease the risk of the development of cardiovascular disease. For women deemed to be at intermediate to high risk for cardiovascular disease, additional dietary recommendations may include supplementation with omega 3 fatty acids.

Manage Weight, Blood Pressure, Cholesterol

Women are also encouraged to  maintain a healthy weight through a balance of physical activity, as well as dietary and behavioral weight reduction or maintenance programs when appropriate. Efforts to maintain normal blood pressure and cholesterol control through either lifestyle approaches or medications are also extremely important, Dr. Feinberg adds.

Medications for Prevention

Aspirin Therapy

Those deemed at intermediate to high risk for cardiovascular disease are also encouraged to speak with their primary care provider or a cardiologist to determine whether specific medications, including  aspirin therapy, are indicated for preventative purposes.

Measuring Risk

"Many patients have an elevated cardiovascular risk score, which can be calculated in the office," she says. "This score assists us in determining the individual patient's risk. Elevated scores may indicate that the woman may benefit from initiation of specific therapies for primary preventative purposes. However, this needs to be carefully weighed by the patient and her physician to ensure that contraindications to taking the specific therapy do not exist." Hormone therapy is not recommended to prevent cardiovascular disease in post-menopausal women, as previously was believed.

Risk Categories

Multiple Factors

Women are determined by their doctor to be at low, intermediate, high, or very high risk of developing a cardiac event based on risk calculators, which take into account many factors. These include those with already established coronary heart disease, peripheral arterial disease, abdominal aortic aneurysm, diabetes, and a combination of risk factors such as smoking status, elevated age, cholesterol profile,  family history of premature coronary heart disease, elevated blood pressure, and/or chronic kidney disease.

The presence of other risk factors such as obesity, sedentary lifestyle, and poor dietary habits are also taken into account.

Avoiding Catastrophe

"I encourage every woman to be proactive in educating herself about her individual risk of cardiovascular disease so that she may be able to attempt to prevent and treat this serious disease process before it leads to a catastrophic and sometimes fatal event," says Dr. Feinberg.

Contact Information

Women's Cardiovascular Health Program
CardioVascular Institute
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215