I wrote a couple months ago about gender bias in the diagnosis of heart disease.

And this week the Chicago Tribune ran a story that really drives home the importance of educating women on the symptoms and prevention of heart disease—including the American Heart Association’s (AHA’s) Guidelines for Preventing Cardiovascular Disease in Women.

Building from a recent study in the AHA’s journal Circulation, the Trib article notes that:

“Too many physicians still discount the idea that a woman could be suffering from heart disease, delaying or denying needed medical interventions, experts note. Most community hospitals in the U.S. still are not following guidelines for treating women with heart attacks. And primary care doctors don’t do as much as they could to emphasize prevention.

As a result, women are failing to reap the full benefits of enormous advances in cardiovascular medicine.”

The article goes on to tell the eye-opening stories of four women who learned that the hard way. They’re worth reading—they’ll get you thinking about your own risks.

According to the Trib, “80 percent of heart attacks in women could be prevented if women changed their eating habits, got regular exercise, managed their cholesterol and blood pressure, and followed other preventive measures.” This reflects the message of the AHA guidelines, which take a long-term view of heart disease prevention and underscore the importance of healthy lifestyles in women of all ages.

The Trib article suggests that women confirm that their physicians follow the guidelines, which is obviously a smart idea. But you should consider familiarizing yourself with them, too. The guidelines were revised in 2007, and the AHA highlighted these changes:

* Recommended lifestyle changes to help manage blood pressure include weight control, increased physical activity, alcohol moderation, sodium restriction and an emphasis on eating fresh fruits, vegetables and low-fat dairy products.
* Besides advising women to quit smoking, the 2007 guidelines recommend counseling, nicotine replacement or other forms of smoking cessation therapy.
* Physical activity recommendations for women who need to lose weight or sustain weight loss have been added—a minimum of 60–90 minutes of moderate-intensity activity (e.g., brisk walking) on most, and preferably all, days of the week.
* The guidelines now encourage all women to reduce saturated fats intake to less than 7 percent of calories if possible.
* Specific guidance on omega-3 fatty acid intake and supplementation recommends eating oily fish at least twice a week and consider taking a capsule supplement of 850–1000 mg of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) in women with heart disease, two to four grams for women with high triglycerides.
* Hormone replacement therapy and selective estrogen receptor modulators (SERMs) are not recommended to prevent heart disease in women.
* Antioxidant supplements (such as vitamin E, C and beta-carotene) should not be used for primary or secondary prevention of cardiovascular disease (CVD).
* Folic acid should not be used to prevent CVD—a change from the 2004 guidelines that did recommend it be considered for use in certain high-risk women.
* Routine low-dose aspirin therapy may be considered in women age 65 or older regardless of CVD risk status, if benefits are likely to outweigh other risks. (Previous guidelines did not recommend aspirin in lower risk or healthy women.)
* The upper dosage of aspirin for high-risk women increases to 325 mg per day rather than 162 mg. This brings the women’s guidelines up-to-date with other recently published guidelines.
* Consider reducing LDL cholesterol to less than 70 mg/dL in very high-risk women with heart disease (which may require a combination of cholesterol-lowering drugs). 

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