Midlife Guide for Women: Heart

If you're like many midlife women, you're probably more worried about breast cancer than heart disease at this point. Chances are you have more than one friend who is struggling with that devastating illness. But breast cancer, as terrible as it is, pales before the leading killer of women: heart disease. Every year, more women die of heart disease than of all kinds of cancer combined. True, at this point in your life, you probably know more women who have been diagnosed with cancer than heart disease, but that will soon change. Before menopause, your odds of a heart attack or stroke are much lower than those of a man your age. After menopause, the odds shift and the risk gap narrows. Women over 65 are just as likely to die of a heart attack as men of the same age. But here's some hopeful news. Recent research shows that even if you haven't been particularly kind to your heart in the past, starting healthy habits now can make a big difference in the years ahead.

Your risk for heart disease is determined by your age, lifestyle, family history and overall health. The more risk factors you have, the greater your chances of heart disease. Here's what you can't change: age, family history and race. Your risk rises as you get older, and you're even more vulnerable if your father or brother was diagnosed with heart disease before 55 or your mother or sister was diagnosed before 65. Black women 44 to 64 are more likely to have a heart attack than white women of the same age for reasons that aren't yet clear to researchers.

If any of these strike home, concentrate on what you can change. If you're a smoker, quitting should be at the top of your list. More than half of all heart attacks in women under 50 are smoking-related, but quitting lowers your risk by a third within two years. If you have diabetes, your chances of a heart attack may triple. Losing weight and keeping your diabetes under control will improve your odds. High blood pressure puts extra stress on artery walls and the heart muscle. You can get your blood pressure under control through diet, exercise and medication. Know your cholesterol levels. If they're high, change your diet, get more exercise and ask your doctor whether you're a candidate for cholesterol-lowering medication. Nearly two thirds of American women over 20 are overweight or obese; if you're one of them, losing even 10 pounds can lower your risk.