By Sandra Gordon

In the U.S., nearly one in three women will die of heart disease or stroke. These occur when a blood vessel that carries oxygen and nutrients to the heart or brain is either blocked by a clot or bursts. Cardiovascular disease kills one woman per minute in the U.S., according to the American Heart Association, representing 421,918 deaths per year. More women’s lives get claimed by heart disease than cancer, chronic respiratory disease, Alzheimer’s and accidents combined. In fact, each year, 55,000 more women die of stroke than men. Because stroke is so common, it’s something all women should be concerned about. Prevention is key. Here’s what you can do to reduce your stroke risk.

1. Know your risk level. Recently updated American Heart Association guidelines for cardiovascular disease prevention in women put women into three risk groups: high risk, at risk and ideal cardiovascular health. It’s important to identify which of the three groups you fit into. For example, you’re at high risk if you’ve already have heart disease because you’ve had a heart attack or a stroke, or have diabetes. You’re at risk if you smoke, have high blood pressure (greater than 120/80), total cholesterol above 200, you’re overweight, don’t exercise and/or eat an unhealthy diet. You fall into the category of ideal cardiovascular health if your total cholesterol is less than 200, your blood pressure is less than 120/80, your body mass index is less than 25, you don’t smoke, you’re physically active and eat a healthy diet. (Only one out of more than 1,900 people fall into this category, according to a “Circulation” study by researchers at the University of Pittsburgh School of Medicine.) Then, based on your risk level, talk to your doctor to determine the best preventive program for you and your heart. If you’re at high risk for stroke because you have diabetes, for example, you’ll want to manage your blood sugar closely. Diabetes is one of the strongest risk factors for heart attack or stroke because high blood sugar can damage blood vessels over time. To learn more about the guidelines and risk levels, visit www.heart.org.
2. Stop smoking. “Smoking is a major risk factor for stroke because it increases blood pressure and the tendency for blood to clot, both of which are independent risk factors for stroke,” Director of Prevention Cardiology at New York-Presbyterian Hospital Lori Mosca said. To stop smoking, don’t do it alone. To increase your chances of success, get counseling and use nicotine replacement or drug therapy, if you need it.
3. Exercise your options. Get at least 150 minutes of moderately-intense exercise each week, such as brisk walking or 75 minutes of vigorously-intense physical activity such as jogging or tennis. Consistency is key for a healthy heart and to help avoid weight gain, which is common as we get older because metabolism slows with age. Obesity is a major risk factor for all cardiovascular disease. Nearly two out of every three women older than 20 are now overweight or obese.
4. Eat it to beat it. What’s good for your heart is also good for the blood vessels that feed your brain. Center your diet around fruits, vegetables and whole grains like oatmeal and whole-grain bread. Eat fish twice a week, preferably fatty fish such as salmon. Limit salt to less than 1,500 milligrams per day. Cut out trans fats and keep dietary cholesterol and saturated fat low by eating fewer fried foods, meat, packaged desserts, butter, cheese and other high-fat dairy products such as sour cream and ice cream. Limit alcohol to one drink daily or less.
5. Know your numbers. Get a check-up to get the facts: What’s your blood pressure, total cholesterol, LDL “bad” cholesterol, HDL “good” cholesterol, triglycerides level, glucose (HbA1c), body mass index, and waist circumference? How do these compare to the ideal? High blood pressure (140/90 or more) can up your stroke risk; 120/80 is ideal. Optimal total cholesterol is less than 200; LDL—less than 160 is ideal if you have ideal cardiovascular health or 70 if you’re at very high risk; HDL—greater than 50 for women; triglycerides—less than 150; glucose—less than 7 percent; your body mass index should be 18.5-24.9; ideally, your waist circumference is 35 inches or less. Try lifestyle tactics to improve your numbers, such as changing your diet and losing weight. If that doesn’t help, talk to your doctor about drug therapy. Also, talk to your doctor before going on menopausal therapy. Certain common medications, such as HRT, raloxifene or Tamoxifen may increase the risk of stroke. If you’re considering going on any one of these, talk to your doctor about your risk and how you can minimize that risk.
6. Talk to your doctor about aspirin therapy. The AHA guidelines recommend daily aspirin use for women with heart disease, diabetes, or stroke to protect themselves from future attacks, unless your doctor tells you there’s a medical reason not to. For women age 65 and older, low-dose “baby” aspirin may prevent heart disease and certain types of stroke. Routine use to prevent a heart attack isn’t recommended for healthy women under 65 though.
7. Don’t ignore symptoms. A common one in women is atrial fibrillation—an irregular rhythm that causes one of the heart’s chambers not to beat properly. A clot can develop because of abnormal blood flow, causing a stroke. If you notice that your heart develops the tendency to occasionally beat rapidly, then slow down and see your doctor. You might also experience other symptoms like lightheadedness or difficulty breathing. A stroke from atrial fibrillation is preventable; blood-thinning drugs, such as aspirin or warfarin (Coumadin) can help. ♥