"We do not want women to go to the drugstore and just start taking this themselves. It is critical that every woman talk to her doctor," said Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital and chairwoman of the panel that wrote the guidelines.
The guidelines also advise daily exercise and less fat, and declare vitamins C and E, beta carotene, and folic acid supplements worthless for preventing heart disease.
The guidelines were published in the journal Circulation with related studies on women's health, including one suggesting that hormone skin patches may be safer than pills for menopause symptoms.
In general, the guidelines aim to get women and doctors to focus on the long-term risk from high blood pressure, smoking, lack of exercise, or being overweight, even if a woman's current health seems fine. Even a single risk factor at age 50 greatly raises the chance of heart disease or stroke later, and only about 10 percent of American women are free of these problems.
"We do not want women to wait until they develop symptoms to begin to take action," Mosca said.
The guidelines were drafted by dozens of groups worldwide, including the American Academy of Family Physicians and the US government. Of the 33 people who wrote the advice, 13 have financial ties to heart drug makers, only three of them to a large degree.
"This is a really good gathering of evidence in women," after years of studies done mostly on men, said Dr. Sidney Smith, heart disease chief at the University of North Carolina at Chapel Hill and past heart association president.
The evidence shows that many more women than thought are at risk of heart disease and stroke, even those whose only weakness was failure to exercise every day.
The advice:
Exercise. Get at least 30 minutes of moderately intense exercise on most and preferably all days, 60 to 90 minutes if you need to lose weight.
Diet. Eat mostly fruits and vegetables, whole grain and high-fiber foods, fish at least twice a week, and little salt. Limit saturated fat to less than 10 percent of calories, 7 percent if possible, and trans fats to less than 1 percent. Limit alcohol to one drink or less a day.
Don't smoke. Use nicotine replacement products if needed to stop.
