The Heart Truth for Women

The Heart Truth for African American Women: An Action Plan

When you hear the term "heart disease," what's your first reaction? Like many women, you may think, "That's a man's disease." But here's The Heart Truth: Heart disease is the #1 killer of women in the United States. One in four women dies of heart disease.

For African American women, the risk of heart disease is especially great. Heart disease is more prevalent among black women than white women—as are some of the factors that increase the risk of developing it, including high blood pressure, overweight and obesity, and diabetes.

But there's good news too: You can take action and lower your chance of developing heart disease and its risk factors. In fact, women can lower their heart disease risk by as much as 82 percent just by leading a healthy lifestyle. This fact sheet gives steps you can take to protect your heart health.

What Is Heart Disease?

Coronary heart disease is the most common form of heart disease. Often referred to simply as "heart disease," it is a disorder of the blood vessels of the heart that can lead to a heart attack. It is a lifelong condition and will steadily worsen unless you make changes in your daily habits.

Risk Factors for Heart Disease

Lifestyle affects many of the "risk factors" for heart disease. Risk factors are conditions or habits that increase the chances of developing a disease or having it worsen. For heart disease, there are two types—those you can't change and those you can control. The ones you can't change are a family history of early heart disease and age, which for women becomes a risk factor at 55. That's because, after menopause, women are more likely to get heart disease. Partly, this is because their body no longer produces estrogen. Also, middle age is a time when women tend to develop other heart disease risk factors.

But most of the risk factors can be controlled. Often, all it takes are lifestyle changes; sometimes, medication also is needed. Here's a quick review of these risk factors:

Smoking. About one in five black women smokes. Quit, and just one year later, your heart disease risk will drop by more than half. There's no easy way to quit but making a plan helps. You also can try an organized program or a medication—ask your doctor if either is right for you.

High Blood Pressure. Also called hypertension, high blood pressure increases your risk of heart disease, stroke, and congestive heart failure. Even levels slightly above normal—called "prehypertension"—increase your heart disease risk.

Black women develop high blood pressure earlier in life and have higher average blood pressures compared with white women. About 37 percent of black women have high blood pressure. Hypertension also increases the risk of stroke and congestive heart failure—and black women have high rates of both.

Lower elevated blood pressure by following a heart healthy eating plan, including limiting your intake of salt and other forms of sodium, getting regular physical activity, maintaining a healthy weight, and, if you drink alcoholic beverages, doing so in moderation (not more than one drink a day). If you have high blood pressure, you also may need to take medication.

One good eating plan, shown to lower elevated blood pressure, is called the DASH eating plan—for a copy of the plan, contact the National Heart, Lung, and Blood Institute (NHLBI) Health Information Center, which is listed in "To Learn More."

High Blood Cholesterol. Nearly half of black women have a total cholesterol that's too high. Excess cholesterol and fat in your blood builds up in the walls of vessels that supply blood to the heart and can lead to blockages. A "lipoprotein profile" tests your levels of the key types of cholesterol—total, LDL ("bad"), and HDL ("good") cholesterol—and triglycerides, a fatty substance in the blood.

Lower cholesterol by following a heart healthy eating plan, being physically active, maintaining a healthy weight, and, if needed, taking medication.

Overweight/Obesity. Nearly 80 percent of black women are overweight or obese, increasing the risk not only of heart disease but also a host of other conditions, including stroke, gallbladder disease, arthritis, and some cancers. If you're overweight, even a small weight loss will help lower your risk. At the very least, try not to gain more weight.

Lasting weight loss needs a change of lifestyle—adopt a healthy, lower-calorie eating plan and get regular physical activity. Aim to lose no more than 1/2 to 2 pounds per week.

Physical Inactivity. Fifty-five percent of black women are physically inactive. They do no spare-time physical activity. Physical activity is crucial for good health, including heart health. Try to do at least 30 minutes of a moderate-intensity activity such as brisk walking on most, and preferably, all days of the week. If you need to, divide the period into shorter ones of at least 10 minutes each.

Diabetes. About 11 million Americans have been diagnosed with diabetes—and another 5.7 million don't know they have it. About two-thirds of those with diabetes die of a heart or blood vessel disease.

The type of diabetes that adults most commonly develop is "type 2." Diabetes can be detected with a blood sugar test. Modest changes in diet and level of physical activity can often prevent or delay the development of diabetes.

Photograph of Diane


"By age 43, I had suffered from congestive heart failure and a damaged heart muscle. My experience with heart disease started with typical symptoms. It took me some time to get my strength back, but now I exercise regularly and eat healthy foods. To me, The Heart Truth is a way of informing women about what they can do to prevent heart disease."

Questions to Ask Your Doctor

  1. What is my risk for heart disease?
  2. What is my blood pressure? What does it mean for me, and what do I need to do about it?
  3. What are my cholesterol numbers? (These include total cholesterol, LDL, HDL, and triglycerides, a type of fat found in the blood and food.) What do they mean for me, and what do I need to do about them?
  4. What are my "body mass index" BMI) and waist measurement? Do they mean that I need to lose weight for my health?
  5. What is my blood sugar level, and does it mean I'm at risk for diabetes? If so, what do I need to do about it?
  6. What other screening tests for heart disease do I need?
  7. What can you do to help me quit smoking?
  8. How much physical activity do I need to help protect my heart?
  9. What's a heart healthy eating plan for me?
  10. How can I tell if I may be having a heart attack? If I think I'm having one, what should I do?

Taking Action

Now that you know The Heart Truth, what should you do? Begin by finding out your "risk profile." See the questions to ask your doctor above. Then begin taking the steps to heart health—don't smoke, follow a heart healthy eating plan, be physically active, and maintain a healthy weight. Start today to keep your heart strong.

To Learn More

NHLBI Health Information Center

Phone: 301-592-8573
TTY: 240-629-3255

American Heart Association

Phone: 1-888-MY HEART

WomenHeart: the National Coalition for Women with Heart Disease

Phone: 202-728-7199

Office on Women's Health

U.S. Department of Health and Human Services
National Women's Health Information Center
Phone: 1-800-994-WOMAN
TDD: 1-888-220-5446

NIH Publication No. 08-5066
Originally printed September 2003
Revised December 2007

The Heart Truth and Red Dress are trademarks of DHHS.