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Women and men are different in many ways, but heart disease and stroke are still the leading cause of death for women over age 35 – the same as men.

How are we different?

• We’re generally smaller than men.

• Our blood vessels also are smaller, so plaque buildup affects us earlier.

• Estrogen protects against heart disease until menopause.

• Women tend to live longer, so we tend to be older when symptoms occur. For that reason, they also have a higher likelihood of already having diabetes, high blood pressure and cholesterol problems by the time they develop heart disease.

• Smaller blood vessels are more difficult to balloon, stent and bypass.

• Symptoms often tend to be more subtle in women than men. Women’s symptoms may include nausea, dizziness, fatigue, shortness of breath, anxiety and “just not feeling right.” Men’s typical symptoms of cardiac trouble may include pressure, tightness or discomfort in or radiating to the chest, neck, jaw, teeth, shoulders, upper back or down one or both arms. Both women and men also may develop any of the previous symptoms. A person who has diabetes also is more likely to have more subtle symptoms.

Ways to prevent or rehabilitate from heart disease or stroke are:

• Don’t smoke. Smoking increases your risk by more than 50 percent.

• Check and control blood pressure, lipids and blood sugars. Blood pressure should optimally be less than 115/75 at rest. LDL cholesterol should be less than 130 if no risk factors for heart disease. If you have risk factors for heart disease, LDL should be less than 100. If you have either heart disease or diabetes, the LDL goal is less than 70. HDL cholesterol should be more than 50 for women (40 for men). Triglycerides should be less than 150. Fasting blood sugars should be less than 100.

• Exercise aerobically at least 30 minutes a day for overall health, 60 minutes a day for weight loss and up to 90 minutes a day to maintain weight loss. Good aerobic exercises include walking, bicycling, swimming, dancing or other activity that keeps your heart rate up for at least 30 minutes continuously. Walking three miles a day or 20 miles a week can decrease risk of heart attack by 50 percent. A 150-pound person could lose 30 pounds in one year by adding three miles of walking a day.

• Eating a heart-healthy diet. This includes eating five to nine servings (1/2 cup each) of vegetables and fruits a day. Try to add more color to your diet. Increase whole grains. Use nonfat dairy products. Choose low-fat options of meat, beans, chicken, fish or turkey.

The bottom line is women need to be concerned about and work to prevent heart disease and stroke the same as men. So move it or lose it! Get out and exercise. Have five colors on your plate and watch portion sizes, especially of higher fat items. Don’t smoke! Discuss your risks with your physician. And, if you are ever concerned about symptoms, call 9-1-1.

Marge Samsoe is an exercise physiologist and diabetes educator at Community Medical Center.

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