Heart disease is the number one cause of death in the United States, and approximately 8 million women are living with the disease. (Here are 10 ways to show your heart some TLC). And though 90% of women have one or more heart disease risk factors in their life, such as smoking, high blood pressure, diabetes, lack of exercise, or high cholesterol, only one in five women believe that heart disease is their greatest health threat. "The biggest myth surrounding heart disease is that we have the disease under control," says Marc Gillinov, MD, a cardiac surgeon at the Sydell and Arnold Miller Family Heart and Vascular Center at Cleveland Clinic and co-author of Heart 411. "The second biggest myth is that women don't have heart attacks. And every year since 1984, more American women than men have died of heart disease." (Search: Find out how healthy your heart is and how to make it healthier).
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One of the most surprising statistics in this grisly picture is that unlike cancer-the second greatest cause of death in US-heart disease is 80% to 90% preventable, says Gillinov. Though you can't control your family history of cardiac events or advancing age (try as we might), you can limit your risk by abstaining from smoking, eating a healthy diet, and exercising regularly, he says. (It's not easy, but we can get you in those skinny jeans in six weeks).
So what do skinny jeans have to do with your heart-besides breaking it when the zipper stops working? Recent studies have shown that waist circumference is a critical tool for helping determine risk for heart disease. In other words, a more svelte figure could save your heart. A recent study published in the Journal of the American College of Cardiology found that participants with a high waist-to-hip circumference or a large waist size-greater than 35 inches for women and 40 inches in men-were 70% more likely to die during the study period than those with smaller waists. And while no single number can provide a complete picture of your health, the study's findings can be explained by the unique danger that abdominal fat poses. "Belly fat is the worst because it's metabolically active," says Gillinov. "It's not just sitting there making your pants too tight. Belly fat can cause insulin resistance [a precursor to diabetes], reduce HDL [good] cholesterol, and increase inflammation and triglyceride levels." (Here are six happy ways to banish belly fat forever.)
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Even if your overall weight is within a normal range, belly fat is still associated with risk factors for heart disease, says Gillinov. In fact, losing enough weight to reduce your waist size by just 2 inches may reduce your risk of developing coronary heart disease by 10% to 15%, according to evidence presented in Heart 411, co-written by Steven Nissen, MD, chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic.
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But what about BMI? When determining whether you're overweight or obese, you're more likely to hear about your body mass index than your waist circumference. BMI is calculated by taking your weight in kilograms and dividing it by the square of your height in meters. (Calculate your body-mass index with our free BMI tool). A BMI between 25 and 30 puts a person in the overweight range; a BMI of 30 or above qualifies that person as obese. However, recent studies have shown that BMI offers an incomplete picture of heart health. BMI doesn't distinguish between different types of fat or its distribution. For example, a woman with a pear-shaped body and a woman with an apple-shaped body could share the same BMI, but the apple-shaped woman, who carries excess weight in her belly rather than in her butt and thighs, is at greater risk for heart disease. BMI also doesn't distinguish between muscle and fat. "Look at LeBron James, a professional basketball player," says Gillinov. "He has a BMI of 27.5, which puts him in the overweight category. But clearly he's all muscle."
Focusing too much on waist measurement is not without its own faults, however. "It's unlikely, but you could come across someone who is 7 feet tall and his waist circumference is 45, far outside the 'safe' range-but that measurement could be OK for him," says Gillinov. What's important is not to rely exclusively on one single number, whether it's weight, BMI, or even waist circumference, he says. "The best first test is to take off your shirt, stand in front of the mirror, and be honest with yourself." And if you can slip into your skinny jeans, you're probably off to a good start.
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