Heart Healthy Living for Women
You may not be aware that heart disease is the number one cause of death in women over the age of 40.
Every year more than 267,000 women die from heart disease as compared to 40,970 women who die from
breast cancer. About 40% of all deaths in women are due to heart disease. Of those women who have
heart attacks, 44% will die within a year compared to 27% of men.
How the Heart Works
The heart is a large muscle about the size of a fist. The major job of the heart is to pump almost 2,000
gallons of blood daily through the blood vessels to all parts of the body. The blood vessels carry oxygen
and nutrients to all parts of the body, as well as the heart itself. They also carry waste products away from
the body’s cells. These waste products are then removed from the body as they pass through the kidneys,
liver, and lungs.
The coronary arteries are the blood vessels that supply the heart with oxygen rich blood. If the blood
vessels to the heart are blocked or damaged, the heart muscle doesn’t get enough oxygen and you can
develop symptoms of chest pain, shortness of breath, or a heart attack. If the heart muscle is damaged,
this can affect how well the heart works and pumps blood out to the rest of the body and organs.
What Causes Heart Disease?
Damage to the arteries is the major cause
of a heart attack. High blood pressure,
smoking, diabetes, or high cholesterol can
cause thickening of the vessels (plaque)
to happen. This thickening can cause the
arteries to become narrowed or hardened.
This is called atherosclerosis. When this
happens, there is a decrease in the amount
blood flow and oxygen to the heart. The
artery can become so blocked that blood
flow cannot reach the heart, the cells within
that part of the heart muscle will die. This
is called a heart attack. This often happens
suddenly when a plaque tears open and a
blood clot forms. When heart tissue has
lost its supply of oxygen, scar tissue will
form. This part of the heart can no longer
work as it should.
What can be done to prevent plaque from forming?
Cholesterol is a soft, waxy substance. It is found in blood lipids (fat) in the blood stream and in all the
cells in your body. The body uses it to form cell membranes, some hormones, and other tissues of the
body. But high levels of cholesterol can lead to blocked arteries and heart attacks.
Blood lipids such as cholesterol or other fats do not dissolve in the bloodstream. They must be carried to
and from the cells by lipoproteins.
LDL – Low density lipoproteins (bad)
ξ Main source of cholesterol buildup in arteries
ξ A high level increases the risk of heart attack and stroke
HDL – High density lipoproteins (good)
ξ Helps keep cholesterol from building up in arteries
ξ Protects against heart disease
ξ Made from the fat in the foods we eat. Also made by the body from carbohydrates.
ξ An excess in the blood can be a risk factor for heart disease.
Cholesterol levels (for women)
Ideal Risk factor
Total cholesterol less than 200 greater than 240
HDL greater than 60 less than 50
LDL less than 130 greater than 160
less than 100 (if heart attack or stroke)
Ideal triglycerides Normal triglycerides High triglycerides Very high triglycerides
less than 110 mg/dl less than 150 mg/dl 150 – 400 mg/dl greater than 400 mg/dl
Signs of a Heart Attack or Stroke
Signs and symptoms of a heart attack are listed below.
ξ Chest pain or pressure (angina) – a deep ache or throbbing pain in the chest, back, throat, left or
right biceps, or forearm. Jaw pain is also possible. Many women and people with diabetes do not
have pain or aching. They many only have the symptoms listed below.
ξ Shortness of breath – with regular activity or worsening shortness of breath with exercise. For
many women, this is the main symptom.
ξ Perspiration – or feeling clammy.
ξ Racing heart – or heart flutters, associated with other symptoms.
ξ Nausea – sudden onset or upset stomach and loss of appetite.
If you have any of the symptoms listed, don’t delay – call 911 or go to the nearest ER.
Signs and symptoms of a stroke are listed below.
ξ Sudden numbness or weakness of face, arm, or leg, often on one side of the body.
ξ Sudden confusion or trouble speaking or understanding speech.
ξ Sudden trouble seeing in one or both eyes.
ξ Sudden trouble walking or dizziness, loss of balance, or coordination.
ξ Sudden severe headache with no known cause.
If you have any of the above symptoms don’t delay – call 911 or go to the nearest ER. Treatment may
work better if started quickly. Every minute counts!
Risk factors for heart disease that cannot be controlled
ξ Increasing age – almost 4 out of 5 people who die from heart disease are over the age of 65. At
older ages, women who have heart attacks are more likely than men to die from them within a few
ξ Male sex – Men are at greater risk for having a heart attack at younger age than women. After
menopause, a woman’s risk catches up to that of a man’s.
ξ Heredity (including race) – if your mother or father died from a heart attack or stroke at an early
age (less than 55 years old), you will be at increased risk for heart disease.
Risk Factors for heart disease that can be controlled
ξ Cholesterol – You should know what your levels are, (total cholesterol, HDL, and LDL). Ask
you doctor to order lab tests if you don’t know your numbers. At about the age 25 your levels
should be checked every 2 -5 years.
ξ Cigarette and tobacco smoke – a smoker’s risk of heart attack is more than twice that of a non-
smoker’s. About 44,000 deaths per year from heart disease are caused by being exposed to side
stream smoke (Side stream smoke is secondary smoke. When you are not smoking, but someone
around you is). Nicotine can briefly increase blood pressure, heart rate, and blood flow, and cause
the blood vessels to constrict and narrow. Cigarette smoke also causes platelets (clotting agents)
in the blood to become sticky and form clusters. These factors make the blood thicker.
Atherosclerosis is also more common in smokers than nonsmokers. Women who smoke should
not use oral contraceptives due to increased risk for stroke or blood clots.
ξ Diabetes – diabetes will increase your risk for heart disease. If you have family members with
diabetes you may be at risk for developing diabetes. It is recommended to keep blood sugar levels
less than 100. Ask your doctor what your target range should be. Being overweight will increase
your risk of developing diabetes.
ξ Blood pressure – blood pressure is the force of
blood against the walls of the blood vessels. Blood
pressure levels can vary throughout the day. Ideal
blood pressure is below 120/80 mm Hg. If your
blood pressure is 120-139/80-89, lifestyle changes
and possibly medicines are needed to prevent heart
Causes of high blood pressure
o family history
o race (African Americans)
o kidney disease
You could have high blood pressure, have no symptoms and feel fine. Long before high blood pressure is
noticed it can damage vital organs in your body. High blood pressure may lead to serious health
problems. Having high blood pressure and atherosclerosis increases your risk for heart disease and
Weight – being overweight increases your risk of heart disease and stroke. It can increase blood pressure,
cholesterol, and triglyceride levels. Excess weight can also increase your risk for diabetes. Losing as
little as 10-20 pounds, can help to decrease your risk for heart disease or other chronic diseases. Ask your
doctor to help you set a good eating and exercise plan. It may be helpful to meet with a nutritionist and an
exercise physiologist. Talk to your doctor about how to lose excess weight. Your body mass index
(BMI) is one of the best ways to know if you are overweight. Your waist size can also be used. You are
overweight if your BMI is between 25.0-29.9. You are obese if your BMI is greater than 30.0.
Body Mass Index (BMI)
21 – 25 Normal risk 21 – 25 Normal risk
greater than 25 Increased risk greater than 25 Increased risk
for disease for disease
This is also used to determine risk.
greater than 40 inches increased risk greater than 35 inches increased risk
for heart disease and diabetes for heart disease and diabetes (for
Asian Americans greater than 31 inches there
is increased risk.)
Exercise – being inactive doubles your risk for heart disease. Some of the benefits of aerobic exercise
(walking, running, biking, and swimming) are listed below.
ξ Lowers blood pressure
ξ Lowers blood sugar
ξ Lowers stress level
ξ Lowers cholesterol levels
ξ Weight control
Aerobic exercise should be done on a regular basis. Aerobic
exercise involves continuous movement of the major muscle
groups that increases your heart rate and breathing rate. If
you exercise for 30 minutes a day at a moderate intensity you
only need to do this 5 times per week. This can even be
helpful if done in three, 10-minute sessions. If you can talk
comfortably and exercise at the same time without gasping
between words, you are not working too hard. If you can sing
and maintain your level of effort you are likely not working
hard enough. If you get out of breath quickly, you are likely
working too hard. You can also use the Perceived Exertion
scale to regulate the exercise intensity. Exercise should feel
fairly light to somewhat hard or an 11-13 on the scale.
Stressful lifestyle – stress that is not managed can also put
you at increased risk for heart disease. Stress can show itself in many forms such as tense muscles,
tension headaches, eating too much, irritability, upset stomach, increased blood pressure and heart rate.
Exercise, meditation, and other relaxation techniques can help to reduce stress.
Eat a well-balanced and varied diet. A heart healthy diet is low in fat and cholesterol. It is also high in
fiber found in grains, fresh fruits, and vegetables. Products that contain soy such as soy nuts, soymilk,
and tofu, may help to prevent atherosclerosis.
ξ Control salt intake. Eat foods high in potassium.
ξ Vitamin supplements. Ask your doctor if you should take a multivitamin
ξ Notify your health care provider if you have any signs of heart disease
ξ Identify and control diabetes
ξ American Heart Association – www.amhrt.org
ξ American Association Family Practice – www.aafp.org
ξ American College Cardiology – www.acc.org
ξ UW Department of Medicine – Cardiology – www.uwhospital.org/
Your health care team may have given you this information as part of your care. If so, please use it and call if you have any
questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical
advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are
different, you should talk with your doctor or others on your health care team when using this information. If you have an
emergency, please call 911. Copyright 7/2014 University of Wisconsin Hospitals and Clinics Authority. All rights reserved.
Produced by the Department of Nursing. HF#5419
9 Very light (easy)
11 Fairly light
13 Somewhat hard