80687 Health Library | Health and Wellness | Wellmont Health System
  • The American Heart Association’s Guidelines for Women

    Woman heart disease image Cardiovascular disease (CVD) is a leading cause of death of American women. Are you at risk? The American Heart Association (AHA) offers a way to classify the likelihood of developing CVD—one that goes beyond the Framingham global risk score. The Framingham score places women in categories (from high risk to optimal) based on factors like age, total cholesterol, and blood pressure. The total score has been to calculate a woman’s 10-year risk of developing the disease. The problem with this is that a low score does not necessarily reflect risk over the course of a lifetime.
    With that in mind, the AHA recommends doctors take a more comprehensive view of cardiovascular risk. Adding to the Framingham score, doctors should examine the person’s medical and lifestyle history, family history of CVD, as well as other genetic conditions. The AHA aims to tackle heart disease in women by evaluating lifetime risk and determining the most appropriate preventive measures. The goals also include more aggressive tactics for those at high risk.
    AHA's classification focuses on three categories: high risk, at risk, and ideal heart health. Women in the “high risk” category have one or more of the following:
    Those “at risk” have one or more risk factors for CVD:
    • Smoking
    • Elevated or high blood pressure
    • Dyslipidemia (cholesterol problems or high triglycerides)
    • Obesity
    • Poor diet
    • Physical inactivity
    • Family history of CVD
    • Metabolic syndrome (a combination of elevated blood sugar, cholesterol, blood pressure, and being overweight)
    • Evidence of subclinical (asymptomatic) vascular disease, such as coronary calcification
    • Poor exercise capacity on treadmill test and/or abnormal heart rate after stopping exercise
    • Systemic autoimmune collagen-vascular disease, such as lupus or rheumatoid arthritis
    • History of pre-eclampsia , gestational diabetes , or pregnancy-induced hypertension
    Women in the ideal heart health category have ideal cholesterol, blood pressure, body mass index, and fasting blood glucose values. A healthy diet, physical activity, and not smoking are also characteristic of those in this category.
    There are also stroke risk factors that are sex-specific or more common in women such as:
    • The use of birth control pills
    • The use of hormone replacement therapy
    • Atrial fibrillation
    • Migraine headaches with aura
    • Depression
    • Emotional stress

    Making Changes for Your Heart

    The AHA recommends these lifestyle changes to prevent CVD for all women:
    • Do not smoke and avoid secondhand smoke. If you do smoke, talk to your doctor about strategies to quit .
    • Get at least 150 minutes a week of moderate exercise or 75 minutes a week of vigorous exercise.
    • Eat a healthy diet that is rich in fruits, vegetables , and fiber . Twice a week try to include fish in your diet. Limit saturated fat, trans fat , sugar, and sodium .
    • Drink alcohol only in moderation. Women should have no more than one alcoholic drink per day.
    • If you are overweight, talk to your doctor about strategies to lose weight. Try to maintain a healthy weight for you.

    Current Disease

    If you have high cholesterol, talk to your doctor about taking omega-3 fatty acids. Your doctor should also screen you for depression .
    In addition, if you have recently suffered a cardiovascular event, such as ( angina , heart attack , stroke , peripheral artery disease ) or have had heart surgery, undergo a comprehensive rehabilitative program to manage your condition and lower your risk of recurrence or other future complications.

    At Risk for CVD

    There are many additional interventions available if you are at risk for CVD. The AHA recommends:
    • Aiming for an optimal blood pressure reading (<120/80 mmHg) and taking blood pressure medication if needed
    • Aiming for healthy cholesterol levels (talk to your doctor about what ideal levels are for you) and taking cholesterol medication if needed
    • Controlling diabetes with diet, exercise, and medication
    • Starting aspirin therapy or other medications if your doctor recommends them


    American Heart Association http://www.heart.org

    Go Red for WomenAmerican Heart Association http://www.goredforwomen.org


    Canadian Cardiovascular Society http://www.ccs.ca

    Heart and Stroke Foundation of Canada http://www.heartandstroke.com


    American College of Cardiology/American Heart Association (ACC/AHA) guidelines for secondary prevention of coronary artery disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated June 3, 2013. Accessed September 9, 2013.

    Estimate of 10-year risk for coronary heart disease Framingham point scores. National Cholesterol Education Program. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/guidelines/cholesterol/risk%5Ftbl.htm#women. Accessed September 9, 2013.

    Explore high blood cholesterol. Diseases and Conditions Index. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/hbc. Accessed September 12, 2012. Accessed September 9, 2013.

    Explore high blood pressure. Diseases and Conditions Index. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP%5FWhatIs.html. Updated August 2, 2012. Accessed September 9, 2013.

    Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women—2011 update: a guideline from the American Heart Association. Circulation. 2011;123(11):1243-1262.

    2/7/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Heart Association/American Stroke Association. Guidelines for the prevention of stroke in women. Stroke. 2014 May.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.