You're under 50. You're pretty fit. You can't have a heart attack, right?
Top left (clockwise): Jennifer Griola, Alissa Gardenhire-Crooks, Debbie Ann Schneider and Loraine Morgan
Truth is, starting at the age of 35, heart disease is the leading killer of women. About 35,000 women younger than 50 die of heart attacks annually -- but only 20 percent of women believe they're at risk for heart disease.
"We really need to bust the myth that this is just a disease of men and older women," says Dr. Nieca Goldberg, medical director of the New York University Women's Heart Program. Sixty-four percent of women die suddenly with their first heart attack without any warning signs at all, and almost all had at least one risk factor that could have been addressed.
"That's why it's critical to figure out your risks and do prevention early on," Dr. Goldberg says. And that's what the women below did. We asked Dr. Goldberg to assess how well their strategies worked -- and to help us all learn how to lower our own risks.
Loraine Morgan, 34
Risk factor: Family history
When Loraine Morgan's dad was told he had high cholesterol, he took a pill and ignored it. Ditto with high blood pressure, and again with diabetes. "He took medications, but didn't make any major life changes," says Morgan, 34, a mother of two with another baby on the way. But then, when her father was 63, one of his toes turned black, a complication of diabetes, and his whole foot had to be amputated. Health.com: How to prevent diabetes complications
The next day Morgan started running and made an appointment to get a physical. She also did some digging on her family history. In addition to her father's health problems, her mom has high blood pressure and high cholesterol. One grandmother had a stroke and one grandfather died of a heart attack. She realized that dealing with illness would be her destiny if she didn't make changes. Health.com: Which statin will lower your cholesterol?
She now runs about 40 minutes a day, five days a week, and lifts weights. "I was the first of my three sisters to change my lifestyle, and they all followed suit," she says. She no longer eats the steak-and-potatoes diet of her parents. Instead, her meals have plenty of fiber, lean protein (she eats fish at least twice a week), and veggies. "Every food decision I make now is because it has the best nutrients for my body," Morgan says.
Dr. Goldberg's take: "Morgan's family has serious risks for diabetes and high cholesterol, so she was at risk, too. But with the lifestyle she's now leading, she's going to prevent it. Her numbers -- BMI, 20; waist, 23 inches; LDL, 96; HDL, 78 -- are all very good. I'd give her an A+ for heart health. Her running is a very big part of her program, and studies show that people at risk for type 2 diabetes who exercise regularly are able to fight it off. She's also created a balanced diet, one she can live with."
Jennifer Griola, 34
Risk factors: Overweight; had borderline gestational diabetes while pregnant
Jennifer Griola, a blogger and mother of two, busts the myth that you have to be thin to be heart-healthy -- her BMI is 30 and her waist is 35 inches. Griola does a high-intensity workout six days a week for 90 minutes. She eats lots of vegetables, prepares her food rather than relying on frozen meals, and rarely eats red meat. Not only has Griola lost about 90 pounds in five years, but her HDL has gone from 47 (in the unhealthy range) to 56, her LDL has dropped from 109 to 94, and her triglycerides (a fat associated with heart disease) have plummeted from 130 to a very healthy 56.
While nursing her first baby, Griola started thinking about her lifestyle and being a better role model for her daughter. That's when she launched her exercise-and-diet program, which she blogs about on www.Lost100.com. "Because I'd been an athlete, I never thought of myself as obese or at risk of a heart attack, but I probably was," Griola says.
Dr. Goldberg's take: "I'd give Griola an A--. She's doing all the right stuff, and she has obviously found success doing it. Some people don't ever start an exercise program because they say it will never work, but she's proof that the scientific data is right: The dramatic change in her triglycerides and her better cholesterol stats came from losing the weight. She needs to reduce her waist size a bit more, which she can do by doing more muscle-strengthening exercise to lower her percentage of body fat." Health.com: Dietary fats can help or harm your heart
Alissa Gardenhire-Crooks, 39
Risk Factors: Family history; high blood pressure
Since grad school, Alissa Gardenhire-Crooks, a social-policy researcher, has had high blood pressure, a not-uncommon condition in African-Americans. In fact, both of her parents have hypertension, and her father had a stroke. But Gardenhire-Crooks' heart stats look great, thanks to her efforts to get in shape and change her diet. (She's also on blood pressure medicine.)
During college and after, Gardenhire-Crooks lost and gained 50 pounds several times and became so frustrated with her weight that she saw a surgeon for bariatric surgery. "I was sad about being so heavy and not feeling good about myself," she says.
While awaiting insurance approval for the surgery, Gardenhire-Crooks started a fitness plan with a personal trainer, who also gave her nutrition advice. She lost 69 pounds, went from a size 20 to 8, and ditched the surgery idea.
Gardenhire-Crooks currently lifts weights three times a week, does cardio six times a week, and blogs about her efforts. Because carbs were a diet downfall, she does carb cycling: She eats no starches three days in a row.
Her BMI is 27.5, HDL (good) cholesterol is 62, and LDL (bad) cholesterol is a low 92.
Dr. Goldberg's take: "African-American women are at higher risk for heart disease and diabetes, but I don't think Gardenhire-Crooks will become a statistic. This woman has a plan that earns her an A-. If she keeps it up, she'll lower her risks for heart disease and type 2 diabetes."
Debbie Ann Schneider, 46
Risk factors: Heart attack at 42; had been a smoker
Four years ago, after Debbie Ann Schneider had logged nearly an hour-and-a-half on the treadmill, she felt a touch of asthma and noticed that her heart rate kept going up even though she was slowing down. She thought of a TV show she'd seen three weeks earlier about how heart attack symptoms differ in women and men. Schneider went to her computer to look up symptoms of a heart attack and recognized a few in herself -- chest discomfort, trouble breathing, nausea, and a general unwell feeling. She drove herself to the hospital.
Schneider had had a heart attack caused by a coronary artery spasm, in which a contraction of the artery stops blood flow to the heart. "If I hadn't seen that TV show, I'd probably be dead," she says.
Schneider's only obvious risk factor was that she had been a smoker (though she had quit five years earlier). She was always fighting to lose 10 or 15 pounds, but she was a vegetarian and always exercised. "I was perfectly healthy and fine," she says.
Now Schneider is considered at higher risk for a second heart attack, and she takes medication to prevent another spasm. But her healthy lifestyle is lowering those risks. She exercises regularly and tries to eat a Mediterranean diet. She takes omega-3 supplements and plant flavonoids, which may help lower her cholesterol.
Dr. Goldberg's take: "Smoking is a major risk factor in heart disease, so it's great that Schneider quit. She didn't have a heart attack because of plaque buildup, but it's important for her to keep exercising and eating right to lower her risks of another heart attack, which go up after a person has one. She has done a great job controlling her cholesterol -- her LDL of 94 is great -- but there's room for improvement, so I'd give her a B+. Schneider needs to reduce her waist size (36) and boost her HDL (53) with exercise and diet." Health.com: 10 easy food swaps cut cholesterol, not taste
Barbara Lesperance, 70
Risk factor: Age
Once women hit menopause and their estrogen levels drop, risks of problems like high cholesterol and high blood pressure go up. But Barbara Lesperance hasn't let menopause or her age affect her heart health.
"I think I'm healthier now than I've ever been," says the mother of four, grandmother of 10, and retired nurse. She does a sweat-inducing 35-minute strength-training circuit at Curves three days a week and plays golf -- she walks the front nine holes -- three times a week. On her nongolfing days, Lesperance and her husband walk 2 miles after dinner. She eats healthy foods like chicken, salmon, and lots of fruits and vegetables and salads. For her efforts, she has lost seven pounds since she retired and her LDL (bad) cholesterol is at an all-time low of 102.
Dr. Goldberg's take: "Lesperance's only risk factor is her age. I think the best thing she is doing for herself, after years of taking care of others, is that she's now taking care of her own health. Her active lifestyle has taken years off her risk. Her exercise regimen is excellent and well-rounded with strength training, walking, and golf. And her healthy HDL level (66) is seen in people who exercise. Plus, her BMI of 22 and 29-inch waist show that she eats right. I'd give her an A."
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