You're never too young—or too old—to start lowering your heart disease risk. Of course, exercising, eating healthy and reducing stress are key throughout life, but due to physiological changes that happen as we age, certain risk factors do become more of a threat.
Stub Out a Social Smoking Habit
Smoking is enemy number one when it comes to heart disease, and even just a few cigarettes can do damage: New research from McGill University in Montreal found that smoking just one cigarette a day stiffens your arteries by a whopping 25 percent. Plus, smoking erases the hormonal advantage you have from estrogen, which can leave you vulnerable to a heart attack before menopause, explains Robert Bonow, MD, chief of cardiology at the Northwestern University Feinberg School of Medicine.
Don't Ignore the Birth Control Factor
Remember that hormonal contraceptives slightly increase the risk of blood clots, so if you've ever had one, make sure to discuss it with your doctor before going on birth control. And if you're currently a smoker, don't take oral contraceptives, because the combo can be especially dangerous, says Sharonne N. Hayes, MD, director of the Women's Heart Clinic at Mayo Clinic in Rochester, Minnesota.
Watch Your Alcohol Intake
Moderate amounts of alcohol can have a beneficial effect on your heart. (By "moderate," we mean one drink a day or about 5 ounces—but many restaurants serve far more than that.) Overdoing it can raise triglycerides, increase blood pressure and lead to weight gain, thanks to all those empty calories.
Start a (Slightly) New Diet
Ni bad eating habits early can help control—or even reverse—your risk of coronary artery disease, so adopt the Mediterranean diet (it's been shown to benefit your ticker). Add more fruit,
vegetables and fish to meals.
Do a Downward Dog
Emotional stress is linked to reduced blood flow to the heart, especially in young women. Unwind daily with yoga, meditation or another rela activity.
Get a Grip on Stress
When you're juggling career and family, it's crucial to find stress management techniques that work. "Untamed stress has a direct negative impact on heart health," says Tracy Stevens, MD, medical director of the Saint Luke's Muriel I. Kauffman Women's Heart Center in Kansas City, Missouri. "The constant bombardment of adrenaline raises blood pressure and destabilizes plaque in your arteries, making it likely to cause a clot or heart attack."
Lose the Baby Weight
No, you don't have to fit into your skinny jeans by the time the baby's 6 months old, but do aim to get back to your pre-pregnancy weight within one to two years. "Carrying around extra pounds can lead to high cholesterol, high blood pressure and other heart disease risk factors," Dr. Bonow says. Also remember that it's easier to lose weight in your 30s than in your 40s, when your metabolism slows down.
It's important to stay connected to friends and family for the sake of your mood and heart. Research at the University of Pittsburgh School of Medicine found that high levels of loneliness increase a woman's risk of heart disease by 76 percent. On the flip side, having strong social support can help lower your blood pressure and improve other cardiovascular functions. Set aside time once or twice a week to call friends, or make a monthly dinner date.
Get Baseline Readings
After your next doctor appointment, jot down your cholesterol, blood pressure and sugar levels and keep them somewhere safe. Knowing your "normal" numbers may help catch future heart complications before they become a big problem.
Make Sleep a Priority
Thanks to peri-menopause, fluctuating hormone levels can interfere with a good night's sleep. But not getting at least seven hours of shut-eye regularly can lead to increased blood pressure, low-grade inflammation and higher levels of the stress hormone cortisol, all of which are harmful for your blood vessels and heart, explains Jennifer H. Mieres, MD, a cardiologist at New York University School of Medicine and coauthor of Heart Smart for Black Women and Latinas. Lack of sleep has also been linked to weight gain. So establish good habits: Turn in (and wake up) at the same time every day—even on weekends—and do your best to relax before going to bed, whether it's watching a favorite funny TV show or reading.
Reassess Your Risk Factors
You may discover that your cholesterol, blood pressure and blood sugar levels have changed in this decade, even if you aren't doing anything differently, says Dr. Hayes. In fact, 22 percent of 40-something women have high blood pressure and 50 percent have high cholesterol (a jump from 38 percent of women in their 30s), according to the National Heart, Lung, and Blood Institute. Also, be sure to get your thyroid checked around 45; hypothyroidism (an underactive thyroid gland), which becomes more common as women get older, can negatively affect your cholesterol levels as well as your heart.
Step Up Strength Training
You start to lose muscle mass more rapidly in your 40s, which causes your metabolism to slow down since muscle burns more calories than fat. Unfortunately, this makes it harder to stave off those extra pounds. To help maintain muscle and keep your metabolism going, aim for two 15-minute sessions weekly of lifting weights, using a resistance band or doing other toning exercises.
Carve out Personal Time
"Between the demands of work and family, it becomes even more challenging to find time for yourself in your 40s," says Dr. Mieres. But it's crucial to do so—not only to help ease stress but also to guard against depression, which commonly crops up in this decade and can raise your risk of heart disease. "Find at least 10 minutes of 'me' time every day to do something—even if it's just chatting on the phone with a friend—that helps you destress and regroup," says Dr. Mieres.
Serve Veggie Burgers
Research from the Harvard School of Public Health found that women in their mid-40s who ate the most red meat were more likely to die of heart disease in the next 20 years. Start a "meatless Monday" tradition in your household.
Around menopause, you tend to gain extra weight around your belly, which can lead to insulin resistance, inflammation and heart strain. Cardiovascular fitness also starts to decline, particularly if you're not that physically active to begin with. "Unfortunately, at this point, women have to burn more calories to stay at the same weight," Dr. Stevens says. Start taking the stairs instead of the elevator whenever you can, walk faster around the mall, or jog to the mailbox to send letters instead of sticking your hand out the car window as you drive by. Small changes really do add up.
Have an ECG
Silent heart abnormalities become more common in your 50s, and an electrocardiogram (ECG) to check your heart's electrical activity can pick them up, says Nieca Goldberg, MD, director of the New York University Langone Women's Heart Center and author of Dr. Nieca Goldberg's Complete Guide to Women's Health. Also ask your doctor if you should have a stress test; this is especially important if you're just starting to exercise.
Besides being good for your cholesterol and blood sugar, pumping up your fiber intake (think whole grains like oatmeal, brown rice and flaxseeds, as well as beans, fruits and veggies) can help prevent constipation—which becomes more of a problem as you get older and your digestive system starts to slow down.
Get Even More Vigilant About Screenings
After you go through menopause and get older, your blood pressure and cholesterol tend to go up, and blood vessels get stiffer. "Have your blood sugar, blood pressure and cholesterol measured yearly," advises Dr. Goldberg.
If you have hypertension or high cholesterol, the way you've been managing it before may not be enough. "As you get older, you may need more aggressive therapy," Dr. Bonow says. "High blood pressure that was controlled with one medication may now require three to control it." Talk to your doctor about whether you need to add to or adjust your medications to control your risk factors.
Be Alert to Symptoms
Now is when the first noticeable symptoms of heart disease may appear, so it's important to know what's normal for your body and be on the lookout for worrisome signs like chest discomfort, shortness of breath or changes in exercise tolerance—meaning you suddenly feel winded going up a flight of stairs or feel unusually tired for no apparent reason, says Dr. Mieres. If these appear, see your doctor pronto!
Cook at Home
It's tempting at this age to eat out more often, but restaurant fare is high in sodium and calories, which may raise blood pressure. For recipe inspiration and instruction, try the SideChef app (free; itunes.com).
Pick Up Your Pace
A Circulation journal study found that after age 65, people who start strolling faster can lower their heart attack risk. Listening to upbeat music may speed up your stride.
Hit the Dance Floor
New research in JAMA Internal Medicine shows that people who feel younger than their actual age have a lower rate of death due to cardiovascular disease, so be sure to devote time to the activities that make you feel more youthful.
SOURCES: JoAnne M. Foody, MD, executive director, Pollin Women's Heart Center, Brigham and Women's Hospital. Jennifer H. Mieres, MD, professor, cardiology and population health, North Shore-LIJ Health System. Chileshe Nkonde-Price, MD, director, Women's Cardiovascular Health Program, University of Pennsylvania. Pamela Ouyang, MD, professor, medicine, Johns Hopkins University.