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Heart & Home: Heart Health Guide Learn how to lower your risk of heart disease in the NWHRC's Heart Health Guide. The Heart & Home campaign is sponsored by Bed Bath & Beyond, REDBOOK magazine and the NWHRC: Partnering to help women get heart healthy.

Visit the Metabolic Syndrome Health Center Order free publications and access the following tools: Are You an Apple or a Pear? Body Mass Index (BMI) Calculator

Healthy From the Heart Learn about the treatment options for coronary artery disease in our Healthy From the Heart brochure. Disponible en Español.

1. What's the difference between angina and a heart attack?

   An episode of angina is not a heart attack. When blood flow to the heart is reduced, chest pain, or angina, can result. If blood flow is nearly or completely blocked, a heart attack can occur, killing muscle cells in the heart. Angina usually disappears with rest or medicine, such as nitroglycerin, while a heart attack requires much more intensive therapy in a hospital. If the pain is severe or doesn't go away, or if the symptoms are those of a heart attack, call 911 and get evaluated at a nearby hospital emergency room.

2. I've been smoking for a long time—isn't it too late to bother quitting?

   The good news is that quitting dramatically cuts the risk to your heart, even during the first year, no matter what your age or how long you've been smoking. Even if you've had a heart attack, you'll benefit from quitting—estimates suggest that a woman's risk of having a second heart attack is cut by 50 percent or more after she stops smoking. Recent AHA guidelines recommend counseling, nicotine replacement and other forms of therapy to help women stop smoking.

3. What's the connection between estrogen and heart disease?

   Prior to menopause, naturally circulating estrogen in a woman's body may help keep her arteries free from atherosclerotic plaque (the buildup of fatty substances, cholesterol, cellular waste and other material) by improving the ratio of LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol. Estrogen increases the amount of HDL cholesterol, which helps to clear the arteries of LDL cholesterol—the kind that contributes to plaque. Estrogen also helps keep the lining of blood vessels strong and pliable.

4. Don't birth control pills cause cardiovascular problems?

   Oral contraceptives used to have much higher doses of estrogen than they do today. Such pills increased the risk of vascular and heart disease, especially among women who smoked. American women today typically use pills that have 35 micrograms of estrogen or less. There is a small risk of heart disease for premenopausal women using a pill that has up to 50 micrograms of estrogen. However, even the lower-dose pills carry a risk of increasing blood pressure, and if you have any cardiovascular symptoms or conditions, or if you have diabetes or insulin resistance, be sure to discuss those conditions with a health care professional before starting the medication. Also make sure your health care professional knows if you smoke. Even with the low-dose pill, smoking boosts the risks of serious cardiovascular problems, particularly in women over 35.

5. What foods are unhealthy for my heart?

   Avoiding saturated fat and cholesterol is important in a heart-healthy diet, especially if you already have heart disease. Saturated fat is found mainly in food that comes from animals. Whole-milk dairy products such as butter, cheese, milk, cream and ice cream all contain high amounts of saturated fat. The fat in meat and poultry skin is also loaded with saturated fat. A few vegetable fats—coconut oil, cocoa butter, palm kernel oil and palm oil—are also high in saturated fat. Cholesterol is found only in foods that come from animals. Egg yolks and organ meats (liver, for example) are very high in cholesterol. Meat and poultry have similar amounts of cholesterol. Include complex carbohydrates (especially from whole grain sources), vegetables and fruits, with only very small amounts of fat.

6. What's the difference between "good" and "bad" cholesterol?

   Cholesterol travels in the blood in packages called lipoproteins. Cholesterol packaged in low-density lipoprotein (LDL) is often called "bad" cholesterol, because too much LDL in the blood can lead to cholesterol buildup and blockage in the arteries. In fact, lowering LDL cholesterol is a major goal of cholesterol management guidelines issued by the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health. Another type of cholesterol, which is packaged in high-density lipoprotein (HDL), is known as "good" cholesterol. That is because HDL helps remove cholesterol from the blood, preventing it from piling up in the arteries. You should aim for low levels of LDL and high levels of HDL.

7. I'm under 40. Should I be concerned about heart disease?

   Yes, because the lifestyle you lead now may be contributing to atherosclerotic buildup in your arteries—the beginning of coronary heart disease. All women over the age of 20 should have their blood cholesterol tested every five years and their blood pressure checked every one to two years. Blood pressure is usually checked every time you visit a health care professional.

8. Isn't exercise dangerous for those with coronary heart disease?

   While physical activity can strengthen your heart and is recommended even for those who have had a heart attack, some types of activity may worsen existing heart problems. Warning signals include sudden dizziness, cold sweat, paleness, fainting or pain or pressure in your upper body during or after engaging in physical activity. If you notice any of these signs, call your —health care professional and/or 911 immediately, and be sure to check with your health care professional before starting an exercise plan if you have a heart condition.

9. Since research shows those who drink moderately have fewer heart attacks, should I add a glass or two of wine to my daily routine?

   Several recent studies have reported that moderate drinkers—for women, this means one drink a day—are less likely to develop heart disease than people who don't drink any alcohol. If you are a nondrinker, this is not a recommendation to start using alcohol. And certainly, if you are pregnant or have another health condition that could make alcohol use harmful, you should not drink. But if you are already a moderate drinker, you may be less likely to have a heart attack. Discuss this topic with your health care professional.

10. Isn't heart disease dictated by genes?

    A family history of heart disease is indeed a risk factor for heart disease, but it plays a smaller role than the risk factors you can control—smoking, diabetes, weight, activity levels, blood pressure and cholesterol levels.