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New Guidelines Show Women How to Avoid Heart Disease

Diet, exercise, screenings are key to thwarting this killer

WEDNESDAY, Feb. 4, 2004 (HealthDayNews) -- Heart disease and strokes kill almost a half million women in the United States every year, but few women consider it their greatest health risk.

To combat that knowledge gap, the American Heart Association on Wednesday issued new guidelines, providing for the first time "evidence-based" recommendations for preventing heart disease and stroke in women based on their individual level of risk.

"Almost every minute, a woman in the United States dies of cardiovascular disease," Dr. Nanette K. Wenger, a member of the AHA panel that wrote the guidelines, said during a teleconference announcing them.

Yet, a survey of more than 1,000 women taken by the AHA in 2003 showed that most women do not view themselves at risk. While 46 percent of those surveyed knew heart disease was the leading cause of death for American women, only 13 percent said they considered it their greatest health risk.

In addition to releasing the new guidelines, the association has declared Friday as "National Wear Red Day," to boost awareness of a woman's risk of heart disease.

The guidelines are based on analysis of available medical literature and scientific studies and were drawn up by experts from the heart association and 11 other professional and governmental organizations. Another 22 organizations endorsed the new guidelines. They were issued simultaneously to health-care providers and to women.

For starters, a woman's individual level of risk should first be determined by her doctor.

Next, the guidelines suggest, there should be different strategies for women at low risk (defined as those who have less than a 10 percent chance of having a heart attack in the next 10 years), intermediate risk (a 10 to 20 percent chance of a heart attack in the next decade), or high risk (a greater than 20 percent chance of an attack).

"What we are saying to women is, you must know your risk," says Wenger.

In general, the guidelines recommend all women follow a heart-healthy diet, maintain a healthy weight, exercise for at least 30 minutes most days of the week, and not smoke.

Beyond that, there are specific recommendations depending on a woman's health status. For instance, daily aspirin therapy is recommended for high-risk women but not for low-risk women. For intermediate-risk women, aspirin therapy can be considered if their blood pressure is under control and their doctor decides the risk-benefit ratio is in their favor.

When blood pressure is greater than or equal to 140/90, blood-pressure lowering drugs are recommended.

Hormone replacement therapy and antioxidant vitamin supplements are not recommended for women at any risk level.

Some doctors have implemented the advice in the new guidelines for years, says Dr. Nieca Goldberg, chief of Women's Cardiac Care at Lenox Hill Hospital in New York City. "A lot of the [recommendations] in the new guidelines are things I have been talking about for a long time," she says.

When a health-care provider determines a woman's risk level, Goldberg adds, he or she uses an instrument based on data collected during the long-running Framingham Heart Study to determine the score.

In simpler terms, Goldberg says, a low-risk woman might be one whose total cholesterol levels are below 200, who does not smoke and does not have diabetes or high blood pressure.

An intermediate risk woman "could be that same woman [as the one termed low-risk] but who has high blood pressure even on medication, whose cholesterol might be about 220," she says.

A high-risk women is one with diagnosed cardiovascular disease or who has uncontrolled high blood pressure or diabetes, Goldberg says.

Once women know their numbers for blood pressure, cholesterol, and body weight, they can take action, the experts say.

More information

For more information on the American Heart Association's Go Red For Women campaign, click here. The AHA also offers more details on women and risk factors for heart disease.

SOURCES: Nieca Goldberg, M.D., chief, Woman's Cardiac Care, Lenox Hill Hospital, New York City; Feb. 4, 2004, American Heart Association teleconference
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