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"Real world" medical advice may be the best way to prevent cardiovascular disease in women, according to new guidelines from the American Heart Association.

Since guidelines for women were first formally published in 2004, they've mostly been based on clinical research findings. The 2011 update considers personal and socioeconomic factors women grapple with as well, in order to help patients and their doctors better understand the risks and take steps to reduce them.

"On the patient side, we hope that we can improve women's awareness about heart disease and improve their ability to make healthy lifestyle choices and take their medication as prescribed," says co-author and primary care physician Rowena Dolor, an associate professor of medicine at Duke University School of Medicine in Durham, N.C.

Researchers also hope primary care physicians will assess a patient's cardiovascular risk more frequently, she says.

The myth that cardiovascular disease -- which encompasses coronary artery disease, stroke and hypertension -- is a man's disease needs to be dispelled, Dolor says.

"We've been trying to increase awareness that it's the leading cause of death in women, much higher than breast cancer," she says.

Every minute, there's a death due to cardiovascular disease in women, says Gregg Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center at the David Geffen School of Medicine at UCLA, who was not an author.

"This constitutes 422,000 deaths a year -- more than cancer, respiratory disease, Alzheimer's and accidents combined," Fonarow says.

The guidelines recommend that women:

*Avoid smoking and exposure to environmental smoke.

*Be physically active, getting 150 minutes a week of moderate exercise or 75 minutes a week of vigorous exercise.

*Establish a comprehensive risk-reduction regime if diagnosed with heart disease or have a heart event.

*Achieve a healthy body weight.

*Eat a diet rich in fruits and vegetables; choose whole-grain, high-fiber foods; eat oily fish at least twice a week; limit saturated fat, cholesterol and sugar; avoid trans-fatty acids.

*Consume omega-3 fatty acids by eating fish, or in capsule form if they have high cholesterol.

The new guidelines aren't a major revision, but they're an important one, says Sharonne Hayes, director of Mayo Clinic's Women's Heart Clinic in Rochester, Minn. Hayes was not an author of these guidelines but was an author of the first version in 2004.

"We still have a lot to do in understanding risks, causes and implications of cardiovascular disease in women," Hayes says, especially in Hispanic and African-American women.

"Current and future research should continue to report gender-specific results so we can see if the benefits and risks of the treatment are similar in men and women and report them in future guidelines," Dolor says.

(c) Copyright 2011 USA TODAY, a division of Gannett Co. Inc.  

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