Last week we discussed why women often don’t get diagnosed and treated for a heart attack quickly enough. In brief,

1. Culturally, we still associate heart attacks with men, so we’re slower to understand and respond when a woman is having one.
2. Women’s heart attack symptoms differ from men’s and so are frequently misdiagnosed or ignored.
3. Women may not demand treatment soon enough or loudly enough.
4. And treatments are largely designed for men’s bodies and may not be appropriate for women.

Educating yourself on the symptoms of heart attack in men and women could mean saving a life – including your own.

But what’s even better than knowing what a heart attack looks and feels like? Never knowing what a heart attack looks and feels like.

Healthier Heart Tip 1: Nutrition

We all know the drill: more leafy greens, cut back on refined sugar, aim for quality, whole-grain carbs, reduce the meats, and boost the nuts, fruits, and veggies. But women’s bodies change during menopause, meaning their nutritional needs change too. Even if you’re not at high risk for heart disease, some dietary adjustments can help you meet your nutritional needs. Here are some special steps women can take to help preserve heart health:

1. Phytoestrogens. Soy-based foods like tofu, tempeh, and soy milk can mimic the protective behavior of estrogen in supporting HDL cholesterol (the good kind). Additionally, many women report relief from menopause symptoms such as hot flashes and night sweats, and this increase in quality of life is good for your heart as well.
2. Saturated fats. After menopause, LDL (bad) cholesterol may rise, so reduce or avoid foods high in saturated fats (red meats, whole-fat dairy products, some vegetable oils).
3. Vitamin D and calcium. While not directly related to heart health, having strong bones makes it a whole lot easier to get the exercise that does help your heart. The jury is still out on how much more Vitamin D and calcium menopausal women need and the best ways to get it, but eating a spinach salad in the sunshine sounds like a plan.

Healthier Heart Tip 2: Exercise

Yep, finding the time and will to exercise is tough, but there are so many massive benefits to women over 40, it’s difficult to overstate the case.

1. Avoid weight gain. As estrogen levels decline, weight often increases. And worse, it generally collects around the middle – and belly fat is a higher heart risk than fat on the hips, thighs, or backside. Increasing activity level (particularly while improving diet, re: Tip 1) can help you maintain a healthy weight.
2. Improve sleep. Many women report interrupted (or frankly, really crappy) sleep during this phase of life, and that can be hard on your heart. Exercising regularly is a great way to improve sleep, but one word of caution: some women report exercising too close to bed time increases the likelihood of night sweats.
3. Reduce anxiety and depression. Regular exercise has therapeutic effects on many people suffering from anxiety and depression, including women in menopause. Anxiety and depression can stress your heart; reduce them for a healthier heart and a happier you.

To maximize health benefit, it’s great to do a lot of things: a little weight-bearing, impact exercise for bone density (like running); strength training to build and maintain muscle (I love rock climbing, my friend Anne swings kettle balls); some good cardio-vascular for your heart and lungs (walking, cycling, swimming); and some focusing activity for strength of body and mind (yoga).

Whatever you do, in whatever combination, try to get in 30 minutes of exercise 5 days a week. Just be sure any increases are made slowly and carefully, so your body is ready for the demand.

Healthier Heart Tip 3: Lifestyle choices

Healthy diet and regular exercise are obvious ways to increase heart health and lower your risk of heart disease. But certain lifestyle choices can have huge heart-health impacts. Two of the biggies: smoking and depression.

Smoking. The 1950s called and they want their bad habit back. OK, we know it’s so much easier to say “quit” than it is to do it, but if you’re at or approaching menopause, now more than ever, you need to snuff out your last cigarette. Women who smoke may enter menopause sooner (meaning fewer years with estrogen’s protective benefits) and can experience more intense symptoms. Quitting smoking can be one of the most profound things you do to protect your future health.

Depression. A 10-year study conducted by Reading Hospital ob/gyn Xuezhi Jiang, MD and colleagues revealed that depression can contribute – significantly – to a woman’s risk of coronary artery disease (CAD) in midlife. According to Dr. Jiang, “We saw a significant difference in the association of depression with the risk for CAD based on a patient’s age. Compared with women aged 65 years and older, women under the age of 65 were far more likely to incur CAD as a result of depression.” Dr. Jiang strongly recommends that any woman at or approaching menopausal age who has a history of depression be proactive and get regular screenings.

Even if your feelings of depression don’t require professional intervention or treatment, all women can benefit from being proactive with their mental health. A big one? Staying social. Because of incontinence, hot flashes, and other “embarrassing” symptoms, women may limit social interaction during this time. Chances are other women in your age group are experiencing similar issues, so get together, talk it out, share solutions, and create the support network that can help you all be healthier.

Quoted or consulted sources:

http://www.health.harvard.edu/heart-health/11-foods-that-lower-cholesterol

http://www.medscape.com/viewarticle/737143_2

http://www.hopkinsmedicine.org/healthlibrary/conditions/gynecological_health/staying_healthy_after_menopause_85,P00545/

http://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/belly-fat/art-20045809

http://www.healthline.com/health/menopause/sleep-problems#2

http://www.endocrinologyadvisor.com/nams-2016/cad-risk-and-depression-in-women/article/527431/

http://www.acsm.org/public-information/articles/2016/10/07/exercise-recommendations-for-menopause-aged-women