St. Francis cardiologist Dr. Rajinder Chhokar wants every woman to be aware that heart disease is not just a man's problem.
"Women have to know that cardiovascular disease is still the No. 1 killer in women," she says.
According to the Women's Heart Foundation about 267,000 women die each year from heart attacks, which kill six times as many women as breast cancer. About another 31,837 women die each year of congestive heart failure.
Dr. Chhokar says every woman can do something to lower her risk of heart disease.
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"First thing is to stay active," she says. "The journey of a thousand miles begins with a single step. So, please start your exercise program as soon as you can even if you do the minimum to begin with."
Staying active doesn't necessarily mean going to a gym.
"Any physical activity is better than nothing," Dr. Chhokar says. "You do get a benefit if you walk just 20 minutes at your own speed."
If you have a desk job, get out and walk for 15 to 20 minutes during your lunch break, she suggests. "If you can't walk sit on a stationary cycle," she said.
She's a big advocate for taking the stairs instead of riding in the elevator.
"We stand by the elevator for a long time waiting for it to come," she says.
Getting some physical activity is particularly important for mothers.
"I strongly believe that if mothers are active, the children will be active," she says. "You just can't ask your kids to do things you won't. Kids are frank enough to say 'mom, how about yourself?'"
"I think if we teach the kids to eat healthy from the very beginning, then that's what they'll like as they grow," she says. "Teach kids to eat vegetables and more fruit and less starchy foods."
Her tips for healthy eating:
Don't eat fried food everyday.
Cut back on saturated fats by learning to cook with olive oil instead of butter. Take the skin off chicken.
Skip fried chicken wings and have grilled chicken breasts instead.
"You can eat pork chops," she says. "Trim away the rim of fat and don't fry them."
Don't assume carb-free diets are healthy.
"Carbs are important to stay satisfied and full," she says.
She encourages women to eat enough protein but not overeat meat. Vegetarians should be sure to add soy products, tofu and lentils to their diets.
"I believe in chicken and fish. And red meats aren't bad... You can eat steak two or three times a week as long as it's not bigger than the palm of your hand," she says, emphasizing that the size of "your palm" is likely to be smaller then the typical serving size at a restaurant.
She encourages patients to eliminate sodas and other sugary drinks from their diets. "Remember those are empty calories," she says.
She's noticed that current research shows that too many people are consuming too much fructose thanks to juice and other sweet beverages.
"Eat fruit, don't drink juice," she advises. Other sugary goodies also need to be evaluated. "Cut back on cookies, cakes and other desserts," she says.
Staying well hydrated can help women feel full.
"Drink a glass of water before you start eating," she suggests. "This can help to curb your appetite and maintain your weight."
Dr. Chhokar reminds women that four ounces of red wine is considered acceptable.
"The thought is, usually, if one drink is good, two is better. That's wrong," she says.
If you're drinking hard alcohol such as whiskey or gin, you need to limit yourself to one ounce.
The more you drink the higher your blood pressure is going to be," she says.
Don't be fooled by those "skinny" cocktails. Though they have fewer calories than regular cocktails they still have carbs.
A positive outlook is a healthy outlook.
"Staying happy about your work makes a big difference," she says. "Depression, being angry, they do contribute to heart problems."
Take small steps to reduce your stress and increase your happiness.
"I think one can change their attitude to life," she says.
Apple vs. pear shapes
Apple-shaped women, those who carry extra weight in their stomach area, have a higher risk for heart diseases than pear-shaped women.
"Waist size is a very important thing," she says.
Unfortunately, as women age fat seems to collect in the stomach area.
Core exercises, targeting the belly, can help. So will making healthier eating choices and getting more exercise.
Birth control and smoking
The combination of taking birth control pills and smoking, increases a woman's risk by 20 to 25 percent, of developing cardiovascular disease.
Female smokers have a higher risk of developing cardiovascular disease than their smoking male counterparts.
In the 1980s, most heart-disease studies were conducted with men's health in mind. "Now people are really paying attention to women," Dr. Chhokar says.
And it's time for women to pay attention to themselves, too.
"Women come late to the hospital, they push their husbands to come early," but women try self-medicating with antacids first, she says.
That can be a deadly mistake.
So can assuming that heart-trouble pain is sharp. "It's really a feeling of pressure, someone standing on your chest." she says. "People say 'Well, it's pressure but it's not terribly bad' and they wait too long."
She urges women who experience chest pressure to follow the advice they'd give their husbands and get to the hospital immediately.
Family history can play a role in a woman's chance of developing heart disease but Dr. Chhokar says many of those hereditary conditions can be treated.
"Genetics do play a role but I don't think we can blame them for everything," she says.
Women should talk with their doctors about family members who have died before age 55, and if there have been multiple family members die of heart disease but they should not develop defeatist attitudes.
"Patients say 'Oh it's in my family I can't do anything.' No. We can do a lot," she says, noting that many conditions that were untreatable just a few years ago are treatable now.
"Don't just blame the genetics. Do something about it."