What top docs wish you knew about heart disease: it's the No. 1 killer of women, beating out all types of cancer combined. Protect your health—and your life—with these 10 expert tips

Shape, Feb, 2008 by Michele Bender

You know that your favorite kickboxing class helps keep your ticker--as well as your figure--in top shape, and that your fast-food habit may cause your cholesterol level to rise. But you're young and healthy, so the chances of having a heart attack or stroke in the near future are pretty slim, right? Wrong. Heart disease kills more women between the ages of 25 and 44 each year than breast cancer. "It's a myth that just men and older people get it," says Kathy Magliato, M.D., director of women's cardiac surgical services at St. John's Health Center in Santa Monica, California.

The good news: Research has shown that 82 percent of heart disease can be prevented through lifestyle changes. To find out exactly what to do to avoid a diagnosis, we went to the country's leading female cardiologists and heart disease experts and asked each of them for the most important step you can take to start lowering your risk today.

"Being thin and fit isn't a heart health guarantee."
--KATHY MAGLIATO, M.D., CARDIOTHORACIC SURGEON AND DIRECTOR OF WOMEN'S
CARDIAC SERVICES AT ST. JOHN'S HEALTH CENTER IN SANTA MONICA,
CALIFORNIA

It's true that being a couch potato and overweight or obese makes you more likely to develop heart disease or have a stroke. But a recent survey from the Society for Women's Health Research found that almost 36 percent of women didn't know that even if you eat right and exercise, you can still have dangerously unhealthy cholesterol levels. "Other risk factors, including age, heredity, and high blood pressure, can be even bigger predictors than weight," says Magliato.

Of course, this doesn't mean you can ignore the scale. "The heart has to work harder to supply blood to a bigger body, so it's constantly under increased stress," says Magliato. "Also, if that extra fat is around your waist, it can interfere with metabolism, increasing your risk of diabetes and raising your cholesterol level." So keep up the good-for-you habits and maintain a body mass index under 25, but also pay attention to your other risk factors.

"Good health habits don't cancel out the negative effects of smoking."
--DAWN CALDERON, D.O., CARDIOLOGIST AND DIRECTOR OF THE WOMEN'S WELLNESS
PROGRAM AT THE DEBORAH HEART AND LUNG CENTER IN BROWN MILLS, NEW JERSEY

Sorry, but there's no wiggle room here: If you light up regularly, your risk of heart disease is two to four times greater than that of a nonsmoker. Studies also show that smokers who have heart attacks are more likely to die (and suddenly--within an hour). "Nicotine puts a lot of stress on blood vessels, deprives the body of oxygen, and accelerates the buildup of plaque in the arteries," says Calderon. It can also lower HDL (high-density lipoprotein, or "good") cholesterol, raise LDL (low-density lipoprotein, or "bad") cholesterol, and make blood platelets stickier, upping the risk of clots.

"Fortunately, it's never too late to kick the habit," she says. A study from the Kurume University School of Medicine in Japan found that longtime smokers who quit had almost immediate improvements in blood platelet function. And according to the surgeon general, after one year off cigarettes, you effectively wipe out half the risk of heart disease caused by your smoking habit; in five to 15 years, the risk of stroke for ex-smokers returns to the level of those who have never smoked. And, no, switching to low-tar and low-nicotine cigarettes won't help since they haven't been shown to reduce your risk of heart disease. In other words, the sooner you kick butts, the better.

"Stress stresses out your heart."
--MOLLY ROBERTS, M.D., CO-DIRECTOR OF THE SYNCHRONICITY CENTER FOR
MIND/BODY/SPIRIT MEDICINE AND A PHYSICIAN AT CANYON RANCH HEALTH RESORT
IN TUCSON, ARIZONA

Stress is a by-product of life, taking a toll on everything from your mood and attitude to your relationships. But left unmanaged, it causes several physical changes in the body that can lead to coronary heart disease, high blood pressure, chest pain, and irregular heartbeats, says Roberts. "It breaks down your immune system, so you're more susceptible to illness, which then forces your heart to work harder." In addition, it increases inflammation in the body, releasing chemicals that can damage blood vessels, and floods the body with stress hormones, like cortisol, which can raise blood pressure and negatively impact how your body metabolizes blood sugar (glucose).

Stress also causes your heart rate to quicken and your breathing to become more shallow. "This then ramps up stress hormone production, making you even more anxious," says Roberts. "On the other hand, when you inhale deeply, you trigger the release of chemicals in the body that are associated with relaxation." Finally, stress kick-starts poor habits, such as smoking or turning to food for comfort.

Learning to cope can ameliorate these effects. "Research shows that reducing chronic stress can actually have a positive impact on heart function," says Roberts, who recommends taking vacations on a regular basis, as well as daily "mini-vacations" where you simply focus on yourself. Practice relaxation techniques, like meditation and deep breathing, and streamline your life so you're concentrating on your top three or four priorities rather than on a million different things. Lastly, make a list of a few activities that bring you joy--like talking to your best friend or doing a crossword puzzle--and make sure you do one of them for at least 10 minutes a day.