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Comprehensive new guidelines from the American Heart Association urge women to get aggressive about preventing heart disease-and the earlier in life the better. Heart disease is the number one killer of women. Even one cardiovascular risk factor at age 50 significantly raises the risk of an eventual heart attack or stroke.


The guidelines were drafted by dozens of groups worldwide and have 33 listed authors. Focusing on preventing cardiovascular risk factors, they simplify risk assessment and offer concrete advice. Here are some key recommendations:


* Exercise at least 30 minutes most days of the week (more for women who need to lose weight).


* Consider taking low-dose aspirin to prevent stroke after age 65. Because of bleeding risks, women should consult their health care provider first. Routine use of aspirin for younger women isn't recommended because the risks outweigh the benefits.


* Eat a diet high in fruits and vegetables, whole-grain and high-fiber foods daily, and oily fish twice a week. Limit salt and fat.


* Control blood pressure, weight, and cholesterol levels.


* Don't smoke.


* Don't have more than one alcoholic drink a day.


* Consider taking omega-3 fatty acid supplements (for women who already have heart disease).



The guidelines recommend against using antioxidant vitamin supplements (vitamins E, C, and beta-carotene), folic acid, or hormone therapy to prevent heart disease. These treatments are classified as not useful or potentially harmful.


The guidelines are accompanied by related articles on women's health in the February 20 issue of the journal Circulation.




Mosca L, et al., Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update, Circulation, published online ahead of print, February 19, 2007, http://circ.ahajournals.org/rapidaccess.shtml.