Your ticker is truly amazing. It beats 100,000 times a day, pumping about 2,000 gallons of blood through some 60,000 miles of arteries, veins and capillaries to get your body through your morning spin class, back-to-back meetings and marathon of evening to-dos. When you finally quit for the day and hit the sack, that 8-ounce hunk of muscle keeps working all night long. It deserves the best care—from wholesome nutrition to relief from damaging stress hormones. The need-to-know info on these pages will help you give it just that.
Fact No. 1: You could be a stroke risk and not know it
More than a third of American women have a systolic blood pressure (the top number) between 120 and 139 mm Hg and a diastolic pressure (the bottom number) between 80 and 89 mm Hg. Technically speaking, those numbers don't qualify as "high," but they still put you at an elevated risk of heart disease and stroke, according to research. If you get a borderline reading like this, don't blow it off. You should be rechecked two or three times over the following month or two, under optimal conditions, says Leslie Cho, MD, director of the Cleveland Clinic's Women's Cardiovascular Center. That means no caffeine or exercise for a half hour beforehand. And try to sit quietly—with your feet on the floor, not dangling from an exam table—for five minutes before you roll up your sleeve.
Results still prehypertensive? Your doc may suggest any of the following lifestyle changes: Lose weight (10 pounds can make a big difference); squeeze in two and a half hours of exercise a week; cut sodium intake to 1,500 milligrams a day; limit yourself to one drink a day; adopt the DASH diet, which is rich in fruits, vegetables, whole grains and low-fat dairy.
Fact No. 2: Pregnancy is a crystal ball for heart health
"It's the ultimate stress test," says cardiologist Paula A. Johnson, MD, executive director of the Connors Center for Women's Health at Brigham and Women's Hospital in Boston. "Weight gain and hormonal fluctuations put so much pressure on your body that any predilection for heart disease may emerge during this time." Studies show that women who develop the complication preeclampsia, for example, have double the risk of heart attack and stroke later in life. And women who get gestational diabetes have a higher risk of heart disease in midlife.
One way to protect yourself: Get back to a healthy weight post-baby and have your blood pressure, cholesterol and blood sugar levels screened at least once a year. Also, tell your health care providers about any complications you had during past pregnancies. "Most women don't know they're at higher risk, because they're not told, and therefore not followed up on," explains Dr. Johnson.
Fact No. 3: Snoozing does your ticker good
Research shows that people who sleep for fewer than six to eight hours a night are twice as likely to have a stroke or heart attack. "When you're sleep-deprived, your dietary habits are not the best," explains Nieca Goldberg, MD, medical director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center. "Your body also churns out more cortisol, which in turn increases blood pressure." These factors promote inflammation, too, and that can make you more vulnerable to all types of disease. Late night? Don't stress—a quick nap can go a long way. Your blood pressure may drop by about 5 percent after a siesta, per a study of almost 400 middle-aged men and women.
Fact No. 4: Docs often miss heart attacks in younger women
While rates of death from heart disease have dropped over the last four decades, there's one demographic for which the statistics haven't budged: women under 55. "Part of the problem is a lack of awareness," says Kathryn Berlacher, MD, director of the Women's Heart Disease Center in the Heart and Vascular Institute at the University of Pittsburgh Medical Center. Women in general don't always experience the classic symptoms of a heart attack, like chest pain or radiating arm pain. More common symptoms for women—such as dizziness and fatigue—are often dismissed as "feeling under the weather," adds Dr. Berlacher. These misdiagnoses are tragic because the longer a heart attack goes untreated, the more damage it can do.
But this isn't the only reason heart disease tends to be deadlier in younger women: "These patients typically have other risk factors as well, like type 2 diabetes," says Dr. Wells. Bottom line: Be alert for these four other symptoms that can foreshadow a heart attack (if you get one, call 911): shortness of breath; pain in one or both arms, neck, jaw or stomach; upper back pressure; and cold sweat, nausea or lightheadedness.
Grocery Shop Like a Cardiologist
For the sake of your circulatory system, you know to stock up on oatmeal, salmon and olive oil. But here are some more surprising items to add to your cart—and three to put back on the shelves—courtesy of Gretchen Wells, MD, director of women's heart health at the University of Kentucky's Gill Heart Institute.
"Besides being chock-full of vitamins, minerals, antioxidants and fiber, it's rich in folate, which improves arterial elasticity to lower the risk of heart attack. Best of all, it's easy to prepare. Buy it prewashed, and pop it in the microwave or use it as the base for a salad."
"Like many other root vegetables, it's high in fiber, which helps lower cholesterol. Plus, this time of year, you can buy it precut at the supermarket. Simply toss it with a little olive oil and roast it in the oven."
"Many women shy away from it because it has a lot of calories, but the calories come from heart-healthy fats, which is why studies show people who include plenty of nuts in their diet have lower rates of heart disease. A tablespoon with fruit or celery sticks is a great afternoon snack."
Best to skip:
"Premade meals are often loaded with sodium. Some pack almost your entire recommended daily amount. Frozen vegetables are usually fine, so buy those instead to throw into omelets and stir-fries."
"Most wrapped nibbles are processed and tend to have trans fats or be high in sugar. Many granola bars, for example, contain as much sugar as a candy bar!"
"I avoid the bakery section entirely. Most of the stuff is high in saturated and trans fats. If you must get a baked good, look for ones with polyunsaturated or monounsaturated oils, skim or reduced-fat milk or egg whites."
RELATED: 10 Best Foods for Your Heart
Got High Blood Pressure?
Check out these surprising research-backed tips to bring the numbers down.
Have more probiotics
Consuming a regular dose of friendly microbes—through supplements or cultured and fermented foods (such as kimchi and kefir)—may lower systolic pressure by 3.56 mm Hg and diastolic pressure by 2.38 mm Hg on average, according to a 2014 review published in the journal Hypertension.
A 2015 study found that people with hypertension who received a weekly treatment—in which superfine needles carry low-level electrical pulses into the body—for six weeks experienced a six- to eight-point drop in systolic pressure and about a four-point drop in diastolic pressure. All you'll feel is a mild tingle. (Promise.)
Drinking or eating from cans or bottles lined with bisphenol A spikes blood pressure almost immediately, according to a 2014 Korean study. This common chemical mimics estrogen in the body, and researchers suspect that it interacts with cells in the heart and blood vessels that are sensitive to the hormone.
RELATED: The 22 Worst Foods for Trans Fat
Which Tests Do You Need?
No matter your age, your MD should be screening you for heart disease. But unless you've got obvious symptoms (chest pain, shortness of breath, irregular heartbeats or palpitations), you can skip the echocardiogram, EKG and nuclear imaging tests. "I see many women in their 30s, 40s and 50s who get these tests when they don't need them," says Dr. Cho. "And some involve radiation, which increases risk of breast cancer." Just keep up-to-date on the screenings below.
Test: Blood pressure
Frequency: Annually, or more often if you have an elevated risk of heart disease.
Test: Fasting blood glucose test
Frequency: Annually. But if you're overweight and have at least one other risk factor, your doctor may recommend that you get the test more often.
Test: Cholesterol (aka fasting lipoprotein profile)
Frequency: Every five years from age 20—or more often if you have an elevated risk of heart disease—and annually after 35.
Yoga For Your Heart
Squeezing in a Vinyasa class may be just as good for your cardiovascular health as walking or biking. A 2014 review of studies found that people who practiced yoga regularly experienced the same drop in BMI, blood pressure, heart rate and total cholesterol as folks who stuck to the other workouts. Researchers credit yoga's muscle-building benefits, as well as the fact that it helps lower stress levels.
When a Heart Attack Strikes
The coronary arteries are the major vessels that feed blood to your heart. When one of them becomes clogged by a buildup of plaque, a section of heart muscle is cut off from the oxygen and nutrients it needs, and the tissue begins to die.
How the Blood Flows
1. The pulmonary vein carries oxygen-rich blood from your lungs into the heart's left atrium.
2. From there, the blood flows into the left ventricle, then gets pumped into the aorta, an artery that shuttles the blood to all parts of the body.
3. Oxygen-poor blood returns via the superior and inferior vena cavae and flows into the right atrium.
4. The blood heads to the right ventricle, then gets pumped into the pulmonary artery and back into the lungs, where it's oxygenated once again.