Attention, Women: Ten Cardiovascular Questions to Ask Your Physician

Sometimes, women are afraid to ask questions about their heart health because they fear they do not know the “right” questions to ask. Barbara Roberts, MD, FACC, board-certified cardiologist and director of the Women’s Cardiac Center at the Miriam Hospital, offers ten cardiovascular questions to ask your physician.

Each of the following questions is important to discuss with your health care provider, because each is personal to you and your body. However, Roberts provides answers that you can use as general guidelines.

Am I at a healthy weight?
If you have excess body fat, especially around your waist, you’re more likely to develop heart disease or have a stroke. As a woman, you have an increased risk of developing high blood pressure, which can lead to heart disease, if you are 20 pounds or more over the healthy weight for your height. A good way to determine if you are at an unhealthy weight is to see if your waist is greater than 35 inches and to caluculate your body mass index (BMI).
Calculate your BMI
How much physical activity should I be doing every week?
You should try to work out a minimum of 30 minutes most days, if not every day. You do not need to do 30 minutes at once. If you feel more comfortable, you can break the time into ten-minute intervals.
Am I at a healthy blood pressure level?
More than 73 percent of women ages 65 to 74 have high blood pressure. High blood pressure makes the heart work harder than normal. This makes both the heart and arteries more prone to damage. High blood pressure raises the risk of heart attacks, strokes, kidney failure, eye damage, congestive heart failure and fatty buildup in the arteries. Blood pressure should be less than 120/80 mmHg.
What is my total cholesterol?
The higher your total blood cholesterol, the greater your risk of coronary heart disease. Cholesterol is a soft, fat-like substance found in the blood and in all the body’s cells. Roberts says, “High cholesterol levels can cause buildup, or plaque, in the arteries. This can cause arteries to narrow, reducing blood flow. Sometimes plaques rupture and this usually causes a clot to form inside the artery. If a clot blocks an artery that brings blood to the heart, it causes a heart attack. If it blocks an artery that bring blood to the brain, it causes a stroke.”

High blood cholesterol has no symptoms, and many people have it without knowing it. Find out what your cholesterol levels are on your next visit to the physician.
More about cholesterol numbers
What are my LDL and HDL cholesterol levels? Why is LDL cholesterol considered “bad”, while HDL is considered “good”?
When too much LDL cholesterol, or “bad” cholesterol, circulates in the blood, it can lead to plaque, which in turn can rupture and cause clotting, resulting in heart attack or stroke. LDL cholesterol of less than 100 mg/dl is the optimal level. Less than 130 mg/dl is near optimal for most people. A high LDL level, more than 160 mg/dl if you have no or one other risk factor, or above 130 mg/dl if you have two or more risk factors for cardiovascular disease, reflects an increased risk of heart disease.

Roberts says, “HDL cholesterol is known as the 'good' cholesterol because a high level of it protects against the formation of plaque. HDL can actually remove cholesterol from plaque, taking it to the liver from where it can be excreted into the bile. In addition, HDL fights inflammation, and inflammation is associated with an increased risk of plaque formation.”
More about cholesterol numbers
How can my diet improve my heart health?
Healthy eating habits can help you reduce risk factors for heart attack and stroke. Eating healthy can assist in the prevention of high blood cholesterol, high blood pressure and excess body weight. Roberts says, “a heart-healthy diet is a plant based diet.”
Learn more
Am I at risk for diabetes? Why would having diabetes increase my risk of stroke or heart disease?
Having diabetes increases your risk of heart disease and stroke, especially if your blood sugar is not controlled. People who are most at risk for diabetes are middle aged and/or overweight. After the age of 60, diabetes affects many more women than men. Roberts says that “women with diabetes have from three to seven times the risk of dying of cardiovascular disease compared to women without diabetes.”
How does smoking affect my heart? Does second-hand smoke affect my heart?
If you smoke, your risk of developing coronary heart disease is two to four times higher than a non-smoker. If you smoke cigarettes (or cigars), you have a higher risk of illness and death from heart attack, stroke and other diseases. The good news is that when you stop smoking your risk of heart disease and stroke starts to drop almost immediately. It’s cut in half after one year without smoking, then continues to decline until it’s as low as a nonsmoker’s risk.

Breathing second-hand smoke can be just as dangerous as smoking yourself. Roberts says, “Constant exposure to other people’s tobacco smoke greatly increases your risk of cardiovascular disease. Not to mention, smoking causes many cancers and emphysema – it even causes premature wrinkling and aging of the skin.”
Can stress have a negative impact on my heart?
As women, we all know what it means to feel stressed. A demanding boss, a sick child and not enough time in the day can make you want to pull your hair out. Too much stress over an extended period of time may create health problems in some people. For example, women under stress may overeat, start smoking or smoke more than they otherwise would. These unhealthy lifestyle habits can lead to cardiovascular problems.
Should I be concerned if I take hormonal birth control?
Today’s low-dose hormonal birth control carries a much lower risk of heart disease and stroke than the early version did. However, women on hormonal contraceptives who smoke or have high blood pressure are at higher risk for cardiovascular disease. Taking hormonal birth control and smoking greatly increases the risk of heart attack.

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