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Heart disease continues to be the No. 1 killer of women in America, which is why Dr. Martha Gulati co-wrote “Saving Women’s Hearts.”

Gulati, director of preventative cardiology and women’s cardiovascular health at Ohio State Medical Center, wanted to educate women on how to prevent the disease, what symptoms they need to be aware of and how to successfully manage it – should it happen.

“Our goal with this book is to separate the facts from the many myths surrounding heart disease, while encouraging women to become more proactive in guarding their health.”

Q: Why is heart disease the No. 1 killer of women?

A: Well, it has to do with the presence of risk factors in our society today. We have more hypertension, more obesity, worsening cholesterol, an increase in metabolic syndrome…(and) a more sedentary population. All this contributes. Ultimately, more than 80 percent of heart disease is preventable.

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Another issue that adds to a woman’s risk though, is how we treat women. We know a woman gets less optimal treatment when they present with a heart attack. And again, it is worse if you are an African-American woman. We don’t entirely know why this is, but this is a priority that we figure out why we treat women differently than men. We also know women who are younger and have a heart attack are more likely to die compared to same-aged men. In addition, we know there are greater delays in initiating care in women and this is important because time is heart muscle when we are talking about a heart attack. Women can delay in getting to the ER and don’t always know to call 911. In addition, doctors can delay care by not recognizing that a woman may be having a heart attack.

Q: At what age should women start getting screened for heart disease?

A: At age 20. This means getting your heart risk factors assessed, knowing both your short-term and long-term risk for heart disease, knowing your cholesterol, blood pressure, weight, waist circumference, getting screened for diabetes and talking about tobacco use, your diet and exercise.

Q: We hear so much about the statistics of heart disease, but still it seems like women aren’t doing enough to prevent it. Why do you think that is?

A:  As a society, we seem to be better at treating a disease than preventing a disease. We need to switch our philosophy. We need to be focused on prevention because so much of heart disease is preventable. It is not just women, it is everyone. But there needs to be a switch in health care to rewarding doctors and patients who work to lower their risk for the number one killer of both women and men.

Q: In the book, you talk about heart-healthy diets and heart-friendly foods. What are your favorite heart-friendly foods, and why?

A: Dark chocolate…in moderation, of course. The reality is dark chocolate is good for your heart. It seems to reduce inflammation (which is the basis of heart disease), so eating a small amount daily may help your heart and for those who like chocolate, will make us happy. But remember, moderation is key! And look for the highest cocoa content…more than 70 percent is better for you. Milk chocolate is not really good for you. I recommend one square a day – about 7 grams a day is what studies showed benefits the heart and inflammation.

Q: Why is sleep so important to heart health?

A: Too little sleep promotes calcium build up in heart arteries, and this can be what ultimately causes heart attacks. (A) study from the University of Chicago, found that every additional hour of sleep was equivalent to lowering blood pressure by 16.5 mm/Hg. Quite profound in terms of impact to heart health.

Too little sleep can raise cortisol levels, which increases inflammation and can destabilize plaques in the heart arteries. This is proposed as one way that sleep can increase the risk of a heart attack.