Women’s Health Month: How to keep your heart healthy in your 20s and 30s

May is Women’s Health Month, and what better way to celebrate than taking care of your heart! After all, heart disease is the number one killer of women in the United States, taking the lives of more women each year than all types of cancers combined.  In fact, the likelihood that a woman will die of breast cancer is about 1 in 30.  The chance that she will die from heart disease is 1 in 3. Given that heart disease is a woman’s disease and that it is predominantly preventable, May seems like the perfect month for me to share some heart-healthy tips for women at every phase of life.

Let's start with those of you in your 20s and 30s.

Although heart disease disproportionately affects older women, it’s critically important to lower your heart disease risk at as young an age as possible.  Heart disease – the build up of plaque in arteries – is a result of the cumulative impact of various risk factors.  So the earlier you start addressing those, the better. 

One of the best things you can do for your heart in your 20s and 30s is to not start smoking -- or vaping.  And quitting if you already smoke or vape. 

About 14% of women between ages 25 and 44 smoke cigarettes.  1 in 5 Americans between the ages of 18 and 29 vapes.  Most people think vaping is much less injurious compared to smoking, but when it comes to heart health, that’s just not true.

For decades, we’ve known that the toxic chemicals in cigarette smoke damage the cells that line blood vessel walls.  That not only reduces blood vessel reactivity so that they can’t dilate properly in response to stress, but also makes them more susceptible to accumulating plaque leading to coronary artery blockages, stroke, peripheral vascular disease and abdominal aortic aneurysms.

What we are beginning to see is that vaping nicotine is probably equally dangerous to blood vessel health, and those negative impacts show up even among younger users with less exposure to nicotine than older smokers. Recent studies have shown that people who vape or smoke have worse blood pressure, higher heart rates and more blood vessel constriction, and can’t exercise as well as people who don’t use nicotine at all.

Plus, we really don’t know what the health effects may be of regularly exposing your respiratory system to the vaporized scents, flavors and nicotine carriers that are part and parcel of e-juice.  Many of these compounds are “generally regarded as safe” by the FDA based on data around ingestion, but their effects on the respiratory system might not necessarily be benign.  For example, workers at a microwave popcorn processing plant became sick with severe lung disorder, later dubbed “popcorn lung” after airborne exposure to butter flavoring chemicals.  What could recurrent exposure to a bubble gum flavor in vape juice do to the lungs of teenage girls?  We have no idea.

Besides avoiding all nicotine-containing products, another important health step during your 20s and 30s is to attain and maintain a healthy weight.  Our bodies respond to food and exercise adjustments most readily when we are young.  I’m not suggesting you have to run marathons or be a stick.  Get your body to a place you are happy with and keep it there – and get back to that place after each pregnancy (I know – easier said than done). 

Making exercise a daily habit now will really help keep you fit down the road.  I started regular exercise at the tender age of 54.  I wish I had started MUCH earlier because regular physical activity has given me so much energy and has helped me feel so much better!  Setting aside time to exercise might feel selfish if you have a young family.  But no one can do this for you.  Plus, don't you want to be that fun, active mom that can keep up with her kids even when they're teens?

I’ve never had a weight issue, but I see many female patients who hit 50 out of shape and markedly overweight. And what I can tell you is that losing weight and getting fit is WAY harder after menopause. Being proactive about attaining and maintaining a healthy weight when you're young is priceless insurance for the future.

Your 20s and 30s are also a great time to start talking to your doctor about risk factors that can only be discovered through testing.

At your annual physical, make sure you have baseline tests for cholesterol and blood pressure. After that, your provider should check your cholesterol blood levels at least every four to six years and your blood pressure every two years, more often if you have a family history of either hyperlipidemia or hypertension. If you have blood relatives who have experienced early heart or vascular events, let your doctor know that.  Under those circumstances, getting your lipoprotein A level checked would be a good idea at this age.

It's also important to note that gestational diabetes and eclampsia/pre-eclampsia are risk factors unique to women that translate into a higher likelihood of developing heart disease down the road.  If you experience any of these during pregnancy, know that controlling all other, modifiable risk factors will be even more important as you age.

And lastly -- but certainly not least! -- don’t forget to eat like those people in the Blue Zones! As we’ve demonstrated many times, eating a colorful diet rooted in whole foods can go a long way to not only improving heart health, but to ensuring healthy longevity. The earlier you include healthier foods in your routine, the better.  And yes, it’s perfectly appropriate for young adults to consume Step One Foods.  You may not need to eat them twice per day for cholesterol control, but you’ll never go wrong incorporating nutritionally dense foods formulated specifically to enhance health into your diet, even if it’s only from time to time.

After Mother’s Day, I’ll be back with tips for women heading into the perimenopausal years.