The American Heart Association’s updated guidelines urge all women to take better care of their hearts’ health.

Published in today’s’ issue of Circulation, the Journal of the American Heart Association (AHA), the new guidelines warn against cardiovascular disease and stroke, and offer pointers for better health.
The AHA stresses that cardiovascular disease is the leading cause of death for American women and that virtually all women are at risk. Instead of discussing older women’s situation and younger women’s situation separately, as having different levels of risk, the association focuses on “lifetime risk.”

“Nearly all women are at risk for cardiovascular disease, underscoring the importance of a heart-healthy lifestyle in everyone,” Dr Lori Mosca of the New York-Presbyterian Hospital and colleagues wrote in their report in the guidelines.

“We have more aggressive recommendations for high-risk women, and strongly emphasize lifestyle strategies to reduce risk in all women,” she said.

Regardless of age, women should take care of theiphysical problems of the heart. The earlier a woman adopts a healthy lifestyle and diet, the more likely she is to benefit from this and reduce her overall lifetime risk.

According to the guidelines, the lifetime risk of heart attack or stroke is nearly 50 per cent for American women. This means that one in every two American women is likely to have the disease sometime in her life.

Women are advised to exercise regularly, the best option being that they walk at a brisk pace for at least 60 to 90 minutes, if not every day (as recommended), at least as frequently as possible.

They should take care to shape up a health-oriented diet including lots of vegetables and fruit, low fat dairy foods and non-saturated fats (saturated fats should be no more than 7 per cent of daily calories). Women should eat oily fish or some other source of omega-3 fatty acids at least twice a week.

Alcohol should be consumed moderately and smoking is best avoided.

Aspirin is highly recommended. “Since the last guidelines were developed, more definitive clinical trials became available to suggest that health care providers should consider aspirin in women to prevent stroke,” Dr Mosca said.

Women at high risk of cardiovascular disease should increase their upper daily dose limit of aspirin to 325 mg a day, said the AHA, up from their previous recommendation of 162 mg a day. Women over 65, regardless of their health, should consider taking a low dose (81 mg) of aspirin every day.

There is also specific advice for women who have coronary heart disease to consider taking a supplement of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The dose depends on the level of triglycerides in the blood.

Hormone replacement therapy and selective estrogen receptor modulators (such as the osteoporosis drug raloxifene) are not recommended to prevent heart disease in women.

Supplements such as vitamin E, C, folic acid and beta-carotene do not prevent heart disease and should not be taken to prevent it. “The new guidelines reinforce that unregulated dietary supplements are not a method proven to prevent heart disease,” Dr Mosca said.

In the United States 42.1 million women have heart disease – that means more than one-third of all American women.