New heart-health advice stresses role of diet

New guidelines to preventing heart disease in women, issued by the American Heart Association yesterday, recommend increasing intake of omega-3 fatty acids and taking folic acid supplements.

The guidelines, published in the journal Circulation, are the first to be based on a woman's individual health and seek to reduce the numbers affected by cardiovascular disease each year. The disease is the leading cause of death for both men and women in the United States and kills nearly 500,000 women each year.

The AHA said the guidelines are based on the highest-quality evidence from all the available research related to heart disease prevention.

The recommended advice varies depending on whether a woman has low, intermediate or high risk of having a heart attack in the next 10 years, based on a standardized scoring method developed by the Framingham Heart Study.

But lifestyle interventions such as smoking cessation, regular physical activity, heart-healthy diet and weight maintenance were given a strong priority in all women, not only because of their potential to reduce existing heart disease, but also because heart-healthy lifestyles may prevent major risk factors from developing.

Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital/Columbia University Medical Center, said: "The concept of cardiovascular disease (CVD) as a 'have-or-have-not' condition has been replaced with the idea that CVD develops over time and every woman is somewhere on the continuum."

Prevention measures, both lifestyle and medical, were divided into classes based on the strength of the recommendation for each level of risk. Class I is the most strongly recommended intervention, followed by Class IIa and IIb.

The guidelines also provide guidance on what not to do, with certain interventions labeled Class III - indicating that an intervention is either not useful or could be harmful, or both. This includes both hormone therapy and antioxidant supplements. "Research has shown that these interventions have no benefit for preventing CVD in women," said Mosca.

Another 22 organizations, including some lay organizations, endorsed the guidelines.