Heart disease is the leading cause of death in women, killing an estimated 400,000 women each year. Since 1984, more women than men die each year from cardiovascular disease, despite advances in medicine which have led to availability of life-saving medications and surgical treatment options. And, while most people know to suspect a heart attack when someone reports crushing chest pain, 60 percent of women who die from cardiovascular disease do not have classic symptoms. Women are more likely to present with upper back or neck pain, shortness of breath, palpitations, indigestion or fatigue. The good news is that lifestyle choices can significantly reduce risk of death from cardiovascular disease. Lifestyle modification may be one of the most important things you can do for yourself and your family. The Nurses’ Health Study followed 80,000 women for 20 years. Women with the healthiest lifestyles had an 82 percent reduced risk of cardiac heart disease. Those women did not smoke, exercised moderately or vigorously for 30 minutes a day, maintained a healthy weight with a body mass index (BMI) of less than 25, kept alcohol intake to a half of glass a day and had diets high in marine omega-3 fatty acids and cereal fiber. Their diets were also low in trans-fats and glycemic load and high in the ratio of polyunsaturated to saturated fats. Vigorous exercise should be about 75 minutes a week and include activities that enable you to work up a sweat and become out of breath, like running or playing sports. Nutritional information as it relates to heart disease continues to evolve. Randomized studies looking at the Mediterranean diet have shown that it improves fasting glucose, lowers systolic blood pressure and markers of inflammation when compared to a typical American Heart Association low-fat diet. In fact, Dr. Walter Willett of the Harvard School of Public Health summarized that for nonsmokers with regular physical activity “over 80 percent of coronary heart disease, 70 percent of stroke and 90 percent of Type 2 diabetes can be avoided by healthy food choices that are consistent with the traditional Mediterranean diet.” The Mediterranean diet is high in fat calories from nuts, olive oil and fish. A diet emphasizing fruits, vegetables, whole grains, nuts, seeds, fish, beans and lentils will contain fiber, antioxidants, unsaturated oils and lean protein. Such a diet will also be low in refined carbohydrates, added sugar and trans- and saturated fats that may accelerate heart disease. Evaluate poor lifestyle choices, such as cigarette smoking, that place your heart at risk. Even smoking one cigarette a day can increase your cardiovascular disease risk. Unfortunately, smoking prevalence has been increasing in women, adolescents and young adults. If you smoke, resolve to quit. Pharmacologic and non-pharmacologic support is available. Quitting smoking lowers your risk of having a cardiac event like a heart attack, even if you have already had one. Marital stress, caregiver strain and financial hardship all contribute to higher rates of cardiovascular disease in women, as do depression, anxiety, anger and hostility. Pharmacologic and non-pharmacologic techniques may be necessary. Physical activity can be helpful for many of these issues, and women who are physically active decrease their cardiovascular disease events by 30-50 percent, even when there are only minor changes observed in their lipids, blood pressure readings and in their HbA1C levels. Regular physical activity has been shown to reduce the risk of diabetes, fibromyalgia, weight gain, some cancers, depression, osteoporosis and symptoms of arthritis. It can be intimidating to start an exercise program and make healthier nutritional choices, but the Hayes Green Beach Wellness Center makes it easy to start an exercise program and participate in its award winning weight management program. All programs are affordable and customized to meet the needs of the individual. When starting or advancing an exercise program, remember that it is influenced by your age, current level of fitness, medical conditions and physical limitations. Talk to your doctor about your plans to make positive lifestyle changes, initiate an exercise program and to better understand your personal risk of heart disease. If you do not have a doctor, Hayes Green Beach Memorial Hospital can help you find the right physician with the knowledge, experience and personalized care that you deserve.