Listen up, ladies: Keeping those you love in good cardiovascular health is largely up to you. Experts at the American Heart Association say that women should take the initiative in promoting healthy tickers in their families—from tracking their cholesterol levels to feeding them a heart-healthy diet.

Acknowledging what research shows—that women make 75% of all health care appointments, decisions and purchases—these experts say that to promote heart health for Americans, they’ve got to get women to step up to the plate—the dinner plate, that is. And preparing healthy meals is just the beginning. The next step is understanding that cholesterol levels are directly affected by diet.

Since women typically do all the food shopping and meal preparation, it’s important for women to see themselves as guardians of their family’s health. With more children and teens overweight than ever before, regular cholesterol checkups are important for every family member.


Cholesterol is produced naturally in your body, and you take it in as you eat. Although cholesterol is necessary for the body to function normally, problems occur with too much cholesterol—namely, plaque that can clog arteries in the heart, the brain or the blood vessels.

Everyone age 20 and older should have their cholesterol checked at least once every five years. Ask your health care provider to run a lipoprotein profile. This is a blood test that is conducted after a 12-hour fast, and it will give you a complete cholesterol picture, including your total cholesterol level.

It will also show you how your total reading is made up of three important elements: the artery-clogging LDL cholesterol, the artery-clearing HDL cholesterol, and triglycerides, a form of fat in your bloodstream.


Regardless of your age, your total cholesterol should be at 200 mg/dL or less. Any result in the 200 mg/dL to 239 mg/dL range is considered borderline high, and cholesterol of 240 or
greater is considered high. If your total number is borderline high or higher, your health care provider will want to talk to you about lifestyle changes and drug options to get your cholesterol back under 200 mg/dL. Health care providers have a wide range of cholesterol-lowering drugs to work with, but most use drugs called statins first because they’re so effective.

Your total cholesterol makeup is also important. Overall, your LDL should be 100 mg/dL or less, and your HDL should be 40 mg/dL or higher. Triglycerides raise your risk for heart disease and stroke. Triglyceride levels that are borderline high (150 mg/dL to 199 mg/dL) or high (200 mg/dL or higher) might need treatment.

Help your family develop habits that will keep their hearts healthy. Serve low-fat, low-cholesterol meals. Choose recipes with less than 7% of all fats coming from saturated fats, and keep total daily cholesterol below 200 mg. Encourage loved ones to engage in at least 30 minutes or more of exercise each day, and work with family members to ensure that everyone maintains a healthy weight.

Women might be the gatekeepers of their family’s heart health, but few realize the risks they face if they don’t protect their own cardiovascular system. Women often associate heart disease with men; but if you’re a woman, you should know you’re more likely to die of heart disease or stroke than any other illness. Heart disease is the number one killer of women.

Children are not immune to heart disease either, with 40,000 born with some type of heart defect each year. Rising obesity rates among our youngest children and teens, coupled with increased sedentary lifestyles among our youth who would rather play video games than soccer, is putting our kids at risk for lifetime heart problems
at earlier and earlier ages.


Women are more likely to neglect their own health while providing care for others. This puts women at even greater risk for heart and stroke complications, because women don’t experience heart attack symptoms in the same way as men. Unlike the sudden crushing pain that most men describe as the onset of a heart attack, women who are having a heart attack say that they feel short of breath, nauseous and faint; have gas-like pains; and have been experiencing ongoing fatigue. Way down there on the list, some women say that they have chest pain.

Do not ignore any of these symptoms. Heart attack signs in women are often very subtle. Women will sometimes put off seeking help for heart attack symptoms because they think, This can’t be a heart problem. If you have any heart-attack symptoms, call 911 immediately. Chew an aspirin, don’t swallow it whole, while waiting for the ambulance. Not everyone should take aspirin: If you’re allergic, if you’re already taking medications to thin the blood (anticoagulants), or if you have bleeding problems, talk with your health care provider before using aspirin.


In addition to knowing your cholesterol number, you should regularly track blood-pressure readings for yourself and your family. Helping everyone understand that high blood pressure can lead to either a heart attack or a stroke is important. If you’ve had three high blood pressure readings—meaning a reading of 130/90 (read “130 over 90”) or higher—during any one-week period, you have high blood pressure.

Blood-pressure readings just slightly below that level, in the 120–139/80–89 range, signal prehypertension, which means you’re developing high blood pressure. Your care provider will advise you to change your lifestyle and take medications if you can’t maintain a blood pressure of 120/80 or lower.

For women who are pregnant, high blood pressure presents a unique risk and can lead to a condition called eclampsia, which can be fatal for both mother and baby. Pregnancy will cause high blood pressure in women who typically have normal blood pressure, and it will make existing hypertension worse.

Hypertension typically occurs in 7% to 10% of pregnant women, usually in the last three months of a first pregnancy, and it’s one of the leading causes of death and illness in pregnant women.


Where you store fat can also be a sign of your cardiovascular disease risk. The traditional pear shape, with the fat in your hips and legs, puts you at less risk for CVD than women who carry their fat in their abdomens and waists (apple shape).

Metabolic or insulin-resistant syndrome increases your risk for heart disease, and about one in four people with metabolic syndrome are women. You might have or be developing metabolic syndrome if your waistline is 35 inches or larger, your fasting triglycerides are 150 mg/dL or higher, your HDL cholesterol is 50 mg/dL or less and you have a fasting blood sugar (glucose) of 110 mg/dL or higher.


Physical activity is vital to reducing heart disease, and walking is one of the best cardiovascular exercises. Cardiovascular exercise increases your heart rate and gets blood flowing at a quicker rate through your bloodstream, strengthening your heart muscles as you call on them to work harder. Walking for 10 minutes, three times a day, can help. Exercise most days of the week for the best results.

And physical activity doesn’t just mean structured exercise—work it into your life by taking the stairs, weeding the garden, washing the windows or cleaning the car. Just get moving!

Heart disease can negatively affect daily living, cause financial hardship, and prevent you and your family from fully enjoying life. A heart healthy diet, avoiding tobacco and physical activity are the keys to heart health for you and your family.


Women who smoke experience one and a half times more deaths from cardiovascular disease than from cancer. If you smoke, use birth-control pills and are 35 or older, your risks for cardiovascular disease—especially stroke—are even higher. Birth-control pills alone don’t seem to increase your risk.

If you smoke, quit! Limit your exposure to secondhand smoke. Enroll in a smoking cessation program or talk to your health care provider about medications that can help you stop smoking.

About the Author: Pamela Stewart Fahs, RN, DSN, is an associate professor of nursing and director of the O’Connor Office of Rural Health Studies at Decker School of Nursing, Binghamton University, in Binghamton, New York.