Know your risk for heart disease

Risk factors you can control
• Smoking. Women who smoke risk having a heart attack 19 years earlier than nonsmoking women. Stopping smoking is the single most important lifestyle change you can make to prevent heart disease.

• Blood pressure. High blood pressure is a major contributor to stroke but has less influence over heart disease. Blood pressure often increases with age, so even if your blood pressure is perfect now, you need to know your numbers and have a high level treated as soon as it tips the cutoff point of 140/90 if you are otherwise healthy.

• Cholesterol. High levels of “bad” low-density lipoprotein (LDL) cholesterol and especially low levels of “good” high-density lipoprotein (HDL) cholesterol are toxic to the inside of the blood vessels and promote the build-up of cholesterol-rich deposits. Either a heart attack or a stroke can occur when these deposits rupture and form blood clots, which are released into the bloodstream and find their way into arteries, where they block blood flow.

• Excess weight. If you're going through menopause, you're prone to putting on weight around the abdomen, which could adversely affect blood pressure, “bad” LDL cholesterol, insulin and blood sugar levels. It's this constellation that significantly increases the risk of both heart disease and diabetes. Women who put weight on around the hips and thighs are still at higher risk for heart disease.

• Inactivity. Routine exercise reduces your risk of heart disease. At the minimum, Dr. Beth Abramson of St. Michael's Hospital in Toronto and a spokesperson for the Heart and Stroke Foundation tells her patients to partake in moderate exercise, such as a power walk for 20 minutes, three times a week. Ideally, people should be walking for 30 minutes most days of the week. Moderate exercise means being short of breath and sweaty, but you should still be able to walk and talk at the same time.

• Poor diet. A common-sense diet features low-fat dairy products, whole grains, plenty of fruits and vegetables and modest amounts of lean meat or meat alternatives.

• Recreational drugs. Cocaine has been associated with heart attacks in young people, and now crystal methamphetamine (meth) is taking its toll among the young as well. Crystal meth causes the arteries to constrict, closing off blood supply and possibly triggering a heart attack.

• Alcohol Intake. Excess alcohol consumption may increase blood pressure and the risk of stroke.

• Stress. Mental stress, whether on the job or at home, doubles heart attack risk.

Risk factors you can't control
• Age. Women tend to be protected against heart disease until they reach menopause, after which they start catching up to men. As a rule, women develop heart disease seven to 10 years before men.

• Family history. Women whose father had heart disease before the age of 55, or whose mother had heart disease before the age of 65, or even whose sibling had heart disease, are at increased risk. You can't change your genes, but knowing that you have "bad" heart genes should be a major incentive to adopt heart-healthy behaviours.

• Diabetes. If you are premenopausal, having diabetes takes away the protection against heart disease that premenopausal status tends to confer on younger women.

Read more:
• How to recognize the signs of a stroke – and to find out if you're at risk
• Foods that lower cholesterol
• 9 ways to reach your weight-loss goals

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