The women's heart risk underestimated

These guidelines are more far-reaching than those released in 2004. They focus not on a woman's immediate risk but what is likely to happen as she ages. Most women carry a higher long-term risk of heart disease than they realize and should act now to prevent heart attacks and stroke, say American Heart Association guidelines issued today.

"Many women can be at low short-term risk, but in the course of a woman's life, she has a nearly 1-in-3 chance of dying of heart disease," says Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital. "It's misguided to think you have a low risk of a condition you have a 1-in-3 chance of dying of.

"Right now, 34% of American women (38 million) are living with heart disease," says Mosca, chairwoman of the heart association's guideline committee. "When you have something that common, it's important we all take action to control our risk."

No one knows precisely why women are less likely to have heart attacks or strokes as early in life as men do. Some experts say a young woman's estrogen levels may be protective; others say the male hormone testosterone is harmful, says Jay Cohen of the University of Minnesota.

Cohen says he welcomes the new guidelines because as many women die of heart disease as men, just at a later age. "Really, we should be worried at 30 and 40 not about what's going to happen in the next five years but what's going to happen later on."

The committee based its recommendations, published in Circulation, on the latest research.

Besides reaffirming the importance of following a balanced diet, exercising, controlling weight and blood pressure, limiting salt intake and quitting smoking, the guidelines attempt to dispel confusion bred by conflicting studies. They also contain some don'ts:

• Don't count on folic acid or use vitamins E, C and beta-carotene for heart disease prevention. A seven-year study of 36,282 participants in the Women's Health Study published in the journal also found no significant benefit from vitamin D.
• Don't use hormone therapy or selective estrogen modulators to prevent heart attacks after menopause. Research shows estrogen-progestin drugs and the modulator drugs such as raloxifene can promote clotting. Evidence on the safety of transdermal estrogen patches is still sketchy, Mosca says.
• Don't take aspirin for heart attack prevention until you're 65, unless your doctor tells you otherwise. The Women's Health Study showed a benefit for women over 65 for reducing both stroke and heart attack risks.

Women under 65 may consider aspirin under a doctor's supervision if their stroke risk is so high that aspirin's benefit outweighs the risk of bleeding.

By Steve Sternberg, USA TODAY. Source: www.wzzm13.com