Risk of Coronary Artery Disease

I'm a 62 year old woman and a friend of mine recently had a heart attack. I smoke and I worry about my risks for coronary artery disease. Is there anything I can do?

There are many ways to reduce your risk of coronary artery disease. One of the most important is to quit cigarette smoking. This alone could reduce your heart attack risk by 30-40%. Talk to your health care provider about smoking cessation--there are several medications that can help you quit.

Regular exercise can also promote heart health. One study from last fall showed a large risk reduction for women who exercised at least 30-40 minutes five times a week. You can work your way up to this gradually, even by parking further away from destinations and steadily increasing walking distances.

Your provider can help you with other risk factor reduction. Cholesterol screening is important, and both "good" (HDL--high density lipoprotein) and "bad" (LDL--low density lipoprotein) cholesterol levels are important to know. Depending upon your risk factors, you may need medications to lower your bad cholesterol or raise your good cholesterol to certain targets. Blood pressure also needs to be controlled--you should get this checked regularly and if it runs above 140/90, it should be treated to reduce your cardiovascular risk. Exercise and weight loss can help, but medications may also be required. Some health care providers are also checking an inflammatory marker called C-Reactive Protein (CRP) to better assess heart attack risk; this may or may not be useful in your case.

Many women ask me if they should get a "stress test" or echocardiogram to evaluate their heart. At present, there is no role for EKGs, stress testing, or echocardiography in women without symptoms. However, you should let your provider know if you have symptoms such as chest pain, increasing shortness of breath with exertion, palpitations, neck, arm, or shoulder pain with exertion, or increasing dizziness or light-headedness.

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