Cardiologist Shares 6 Things You Should Never Do for Heart Health

Women’s cardiovascular health has historically been underdiagnosed, understudied and undertreated. In fact, not long ago we learned that women’s cardiovascular biology differs from men, who have always been at the center of the health system.

Heart disease is the leading cause of death for both sexes in the United States, according to the Centers for Disease Control and Prevention. Cardiovascular disease kills more women than all forms of cancer combined, but many women are still unaware that cardiovascular disease is their greatest health threat. In fact, nearly 45% of women over the age of 20 live with some form of cardiovascular disease. For women in particular, certain health patterns that emerge in childhood may lead to or predict the development of certain heart diseases in the future.

For example, having your first period at or before age 10 increases your risk of cardiac events. Pregnancy complications such as preeclampsia and gestational diabetes can also be warning signs of future heart problems. Both early menopause and postmenopause are considered risk factors for cardiovascular disease in women.

Other common health conditions in women can increase the risk of heart disease, including migraine, polycystic ovarian syndrome, lupus, rheumatoid arthritis, psoriasis, and inflammatory bowel disease.

Screening for cardiovascular disease must become as routine as a mammogram or Pap test. There are screening tools, including risk calculators and a calcium score test, both of which can help predict a woman’s future risk of heart attack or stroke.

Although you may not be able to control some heart disease risk factors, 80% of cardiovascular disease can be prevented through lifestyle choices. You can prioritize heart-healthy habits, like exercising regularly, eating a balanced diet, and not drinking or smoking.

These choices can be difficult to follow – I get it! Taking care of your heart can seem like a job in itself, so these six non-negotiables help me succeed.

I would never explain the pain or discomfort

If you’re experiencing chest pain, it could be acid reflux, heartburn, or stress, but it could be related to a heart problem. Many aspects of the heart could be responsible for your discomfort, from the arteries to the valves to the lining of the heart, and a cardiologist can explore these elements to identify the source of your pain.

Even mild or brief pain can be a warning sign of something more serious. Other possible signs of heart problems may include: jaw pain, shoulder pain, feeling like your bra is too tight, feeling short of breath when you walk, fatigue, symptoms flu-like symptoms, sweating, nausea and sudden limitations when exercising.

Once you notice something is wrong, timing becomes crucial. Chest pain and other cardiac symptoms can occur weeks before a cardiac event. Early intervention therefore makes all the difference.

Starting in your 20s, you’ll want to start tracking these four numbers:

• Arterial pressure
• Cholesterol
• Blood sugar
• Body mass index

An ideal blood pressure is 120/80 mm Hg, and anything above 130/80 mm Hg is considered high blood pressure.

A cholesterol or lipid panel displays four numbers: total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides.

Cardiologists look at all cholesterol values, but especially your LDL, or “bad” cholesterol. High levels of LDL can damage the delicate lining of your arteries, leading to plaque buildup in the artery walls. Plaque on the artery walls can cause chest pain and shortness of breath, and if this plaque ruptures, it can lead to a heart attack or stroke. An ideal LDL range is less than 100.

If you already have heart disease, your doctor will probably prefer to see LDL levels below 70. And if you’re at particularly high risk, that level should be below 55. When it comes to LDL, the higher it is the lower, the better.

Cardiologists are also increasingly looking for lipoprotein(a), a genetically determined type of cholesterol associated with heart disease, stroke and aortic valve disease. Cardiologists have recently started recommending that patients get screened at least once in their lives.

You should also pay close attention to your A1C, which measures average blood sugar levels over the past few months. A number between 5.7 and 6.4 is considered prediabetes, according to the American Diabetes Association. A reading of 6.5 or higher is considered diabetes, and anything below 5.7 is considered normal.

BMI is not always a perfect marker of health because it does not take muscle weight into account. In general, however, a BMI between 18 and 25 is considered normal, between 25 and 30 is considered overweight, and above 30 is considered obese. If you find yourself overweight or obese, talk to your doctor.

I will never be ignorant of my family history

Everyone should ask their family members about their cardiovascular health history. Say your mother or sister had a cardiac event such as a stroke, heart attack, stent or bypass surgery before age 65 – this tells the doctor that you have a positive family history. And if you have a male parent or sibling who experienced the same events before age 55, this is considered an early positive family history.

Other conditions affecting the heart can also be genetically determined and passed down. It is important to ask yourself if you have a family history of heart failure, sudden cardiac death, electrical abnormalities of the heart, aortic aneurysms, or high lipid levels.

I would never think that I am immune to heart disease

There is no picture of what someone with heart disease looks like. Even if you’re active, eat healthily, and don’t smoke or drink, you’re not necessarily safe and could still develop coronary heart disease. Additionally, even if your arteries are healthy, you could have a tight or leaky heart valve, aortic aneurysms, heart valve disease, arrhythmias, or cardiomyopathies.

Remember, heart disease is the leading cause of death in both men and women, so everyone needs to consider their risk.

I would never neglect stress management or mental health

There is a connection between the mind and the heart, and too much stress can lead to cardiac events, including heart attacks. So I ask each of my patients about their stress level and what they do to alleviate that stress.

For people suffering from unavoidable stressors, I recommend taking short breaks to reduce your stress throughout the day to avoid constantly being in fight or flight mode. For example, I recommend meditating for even 10 minutes a day and taking short walks. Although you may not be able to completely eliminate stress from your life, finding time to reduce it can make all the difference.

I also ask patients about their mental health. Anxiety, depression, and other issues like PTSD can all affect your cardiovascular health. A therapist can be a big help even if you don’t suffer from mental health issues, and connecting with your support system of friends and family can be invaluable.

I would never skimp on sleep

Sleep has not been given enough emphasis when it comes to matters of the heart. Many bodily processes occur while you sleep, and not getting enough of them has been linked to poor cardiovascular health. Sleep disordered breathing, such as sleep apnea, can contribute to high blood pressure and abnormal heart rhythms.

I generally recommend patients aim for seven to eight hours of sleep and prioritize consistent sleep hygiene before bed – this includes sleeping in a cool, dark room and avoiding screens so your mind can relax. If my patients are having trouble falling and staying asleep, I will suggest a sleep doctor, who will investigate the possibility that they have sleep apnea or insomnia.

Heart health isn’t easy. It’s something you need to make an effort to prioritize, from diet and exercise to keeping doctor appointments and monitoring changes in your body. I’m a cardiologist and I still have days where I struggle to eat a nutritious breakfast or get up early enough to go on the treadmill.

It’s tough, but these small choices pay off, like gradually increasing your heart health savings account. It’s essential that every woman prioritizes her cardiovascular health and makes sure she finds a doctor who makes her feel seen and heard. Make sure you nurture and love your heart – it’s one of the most precious relationships you’ll ever have.