The American Heart Association has updated its guidelines for preventing heart disease in women. The new guidelines urge all women to do more specific things to protect themselves against heart disease and stroke.
The guide is published in today’s issue of Circulation, the Journal of the American Heart Association (AHA).
Cardiovascular disease is the leading cause of death for American women.
Marking a departure from the last issue in 2004, the AHA stresses the importance of focusing on “lifetime risk”. Instead of differentiating between younger and older women with differing levels of risk, they are preferring to focus on lifetime risk, since the earlier that a woman adopts the strategies they recommend regarding lifestyle and diet, the more likely she is to reduce her overall lifetime risk.
The panel that put together the guidelines say that the lifetime risk of heart attack or stroke is nearly 50 per cent for American women. That is one in every two America women is likely to have the disease sometime in her life.
The AHA guidelines contain advice to all women about exercise, lifestyle and diet and a specific recommendation that women over 65, regardless of their health, should consider taking a low dose (81 mg) of aspirin every day.
They recommend a number of things all women should do to keep their lifetime risk of cardiovascular disease to a minimum. Above all they should maintain a healthy lifestyle that includes regular daily exercise, eating lots of fruit and vegetables and mostly non-saturated fats (saturated fats should be no more than 7 per cent of daily calories), and last but not least, avoid smoking.
The new advice on exercise to maintain a healthy weight recommends moderate to intense activity equivalent to a brisk walk for at least 60 to 90 minutes, preferably every day.
More specific advice on diet for keeping blood pressure down is to watch sodium intake, stick to low fat dairy foods, exercise to reduce weight, and moderate the alcohol intake.
Women at high risk of cardiovascular disease should increase their upper daily dose limit of aspirin to 325 mg a day, said the AHA. This is up from their previous recommendation of 162 mg a day.
There was 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.
Meanwhile a new US study reported in today’s issue of the journal Neurology also suggests that lower levels of certain cholesterols reduces risk of stroke in women. The study examined over 27,000 healthy women in their late 40s and over who took part in the Women’s Health Study based in the US and Puerto Rico.
The researchers, led by Assistant Professor of Medicine at Boston’s Brigham and Women’s Hospital Dr Tobias Kurth, took measurements of the women’s cholesterol levels, for different types of cholesterol at the start of the study. They then followed their medical progress at intervals over the susequent 11 years.
On average for each year of the study about 9 out of every 10,000 women had a stroke.
The results showed that a high total initial cholesterol level conferred a 2.3 times greater risk of stroke, with bad cholesterol (LDL) conferring 1.7 times. When the good cholesterol (HDL) was taken out of the equation, the remaining non-HDL cholesterols between them conferred an almost 2.5 times increased risk of having a stroke.
The authors point out that one of the limitations of the study is that they only measured cholesterol at the start.
Some experts have suggested that because the women involved were mostly white and well educated (they were all health care professionals), the results are not representative of the US population at large.
For example, it is likely that because of their level of education and their profession, they would have been more health aware and more likely to be taking precautions to keep their cholesterol levels down. So the suggestion is that these figures could be worse for the rest of the population.
“Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update.”
Lori Mosca et al
Published online before print February 19, 2007
Circulation 2007, doi:10.1161/CIRCULATIONAHA.107.181546
“Lipid levels and the risk of ischemic stroke in women.”
T. Kurth, B. M. Everett, J. E. Buring, C. S. Kase, P. M. Ridker, and J. M. Gaziano.
Neurology 2007 68: 556-562.
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Written by: Catharine Paddock
Writer: Medical News Today