The Heart Disease Prevention Guide for Your 20s, 30s, and 40s

Your 20s

Even though heart disease kills more women than breast, lung, and ovarian cancers combined, only 1 in 10 women see themselves at risk. Before you say, "But I don't have to worry about that until I'm 50," consider this: Studies show that heart trouble -- including clogged arteries and high cholesterol -- can start as early as childhood. The positive news: you have some control over your risk, since more than 80 percent of all heart disease in women is avoidable. In fact, taking protective measures in your 20s, 30s, or 40s can help lower your odds of developing heart problems by as much as 60 percent. Here are the preventive steps you should take in each decade, starting now.

Believe it or not, heart trouble can start surprisingly early. Several studies have found that a large number of young people have early buildup of cholesterol in their arteries. Researchers recommend making healthy lifestyle choices, such as not smoking, drinking within moderate limits, exercising daily, and eating a healthy diet. The earlier you start to alter your habits, the easier it will be to maintain a healthy heart throughout your life.

Make an appointment with your doctor for a complete physical with lab work by age 20 (see chart below). "The important thing at this time is becoming aware of your personal risks," says Sharonne N. Hayes, MD, director of the Women's Heart Clinic at the Mayo Clinic in Rochester, Minnesota. If you have any risk factors, talk to your doctor about ways to lower them through diet, exercise, and medication if needed. Here's a quick rundown of the crucial basic screenings:

Test: Blood Pressure
Should be: Below 120/80 mm Hg

Test: BMI
Should be: 18.5?24.9 kg/m2

Test: Cholesterol
Should be: Total, less than 200 mg/dL; LDL (bad), less than 100 mg/dL

Test: Triglycerides
Should be: Less than 150 mg/dL

Test: Fasting Blood Sugar
Should be: Below 100 mg/dL

"Lighting up more than doubles a woman's odds for developing coronary heart disease," says Nieca Goldberg, MD, chief of women's cardiac care at Lenox Hill hospital in New York City and author of The Women's Healthy Heart Program: Lifesaving Strategies for Preventing and Healing Heart Disease (Ballantine Books, 2006). Within one year of quitting, your risk of coronary heart disease decreases by a whopping 50 percent.

A first-degree female relative (a mother or a sister) who has a heart attack at age 65 or younger increases your risk of heart disease, says Barbara Roberts, MD, director of the Women's Cardiac Center at the Miriam Hospital in Providence and author of How to Keep from Breaking Your Heart: What Every Woman Needs to Know About Cardiovascular Disease (Jones and Bartlett, 2004). The same holds true if a male relative has suffered a heart attack at age 55 or younger, she says. But don't panic if you have a strong family history of heart disease -- making lifestyle changes in your 20s can significantly lower your risk.

Replace pepperoni pizza with a veggie slice; trade sugary cereals for oatmeal or other whole grains, which add fiber, helping to shuttle cholesterol out of your bloodstream. Other heart-friendly foods include blueberries, kale, strawberries, spinach, brussels sprouts, plums, broccoli, beets, oranges, and red grapes. All contain high levels of antioxidants, which help prevent hardening of the arteries. Omega-3 fatty acids, found in fatty fish, walnuts, and flaxseed, protect against inflammation, another heart disease risk factor. "They may also help lower LDL cholesterol levels and can prevent blood clots," says Suzanne Steinbaum, DO, a cardiologist and director of the Center for Cardiac Health at Beth Israel Medical Center in New York City.

This is the decade to make exercise a habit. A study in the New England Journal of Medicine reports that both walking and vigorous exercise can reduce cardiovascular events such as heart attack and stroke in women, regardless of their age, BMI, or race. Aim for 30 minutes of moderate-intensity exercise on most, if not all, days. If you don't have time for 30 minutes straight, break it up: Take a 15-minute walk at lunch and then another one after dinner.