In 2004, the American Heart Association (AHA) released new guidelines for preventing heart disease and stroke in women, based on a woman's individual cardiovascular health. Those guidelines, still in effect today, adopted the idea that cardiovascular disease (CVD) develops over time and that women fall somewhere along a continuum, based on a variety of factors. This concept replaced the earlier idea that women either had or did not have CVD.
Guidelines at a Glance:
- Prevention should be tailored to a woman's individual level of risk for cardiovascular events.
- Smoking cessation, regular physical activity, a heart-healthy diet, and weight maintenance are a strong priority.
- ACE inhibitors and beta-blockers are recommended for all high-risk women.
- High-risk women should be prescribed statin therapy even if their LDL cholesterol levels are below 100 mg/dL.
- Niacin and fibrate therapies are given a strong recommendation for high-risk women with specific cholesterol abnormalities.
- Aspirin is recommended for prevention in all high-risk women and is not recommended for low-risk women. For intermediate-risk women, aspirin can be considered as long as blood pressure is controlled and the benefit is likely to outweigh the risk of side effects.
- Blood pressure-lowering drugs are recommended when blood pressure is greater than or equal to 140/90. Diuretics should be part of the drug regimen for more patients unless contraindicated.
- Women with atrial fibrillation and intermediate or high risk for embolic stroke should take warfarin. If they cannot take warfarin, or if they are at low risk, they should be given aspirin.
- Women with diabetes must have their blood sugar carefully controlled, as defined by achieving near-normal glycosylated hemoglobin levels (less than 0.7 percent).
- Hormone therapy and antioxidant vitamin supplements are not recommended for CVD prevention.
- Women with cardiovascular disease should be evaluated for depression and treated or referred for treatment when indicated.
- In addition to a heart-healthy diet, supplementation with omega-3 fatty acids and folic acid may be considered in some high-risk women.
NOTE: Talk to your doctor about what steps you should take.