Though most women live in fear of developing breast cancer, most don't realize that heart disease poses an even bigger threat.

In fact, the number-one cause of death among American women is coronary heart disease. One in 25 women will die of breast cancer, but as many as one in three women will die of heart disease. The following statistics show why, as a woman, you should be taking heart disease to heart:

• Since 1984, heart attack, stroke and other cardiovascular diseases have killed more women than men.
• More than 1 out of 5 women have some form of cardiovascular disease.
• Cardiovascular diseases kill more women than all forms of cancer, chronic lung disease, pneumonia, diabetes, accidents and AIDS combined.
• In 64 percent of women who died suddenly of coronary heart disease, there were no previous symptoms of this disease.
• Within six years after a recognized heart attack: 33 percent of women will have another heart attack, 25 percent will develop angina, 13 percent will have a stroke, 30 percent will be disabled with cardiac failure and 7 percent will experience sudden cardiac death.

Unfortunately, after menopause, as your body's supply of that wondrous hormone estrogen declines - and your likelihood of developing heart disease increases. Researchers believe estrogen helps to keep cholesterol levels in check and protects women from heart disease. After menopause, your total cholesterol could increase by as much as 6 percent, increasing your risk of heart disease - unless you take action.

Taking charge

OK, you can't prevent yourself from getting older and you can't change your family's medical history of heart disease. But there are plenty of other things you can do to head off your risks at the pass.

1. If you smoke, quit. Smoking has been linked to heart disease again and again, so why go there? In fact, smoking is the single greatest preventable cause of death in the United States, including heart disease. Once you do kick the habit, within three years your risk of heart disease levels out to that of a nonsmoker's. So the damage to your body following years of smoking can be reversed relatively quickly.
2. When was the last time you had your blood pressure checked? It may be high and you don't know it. High blood pressure makes the heart work harder than normal, which causes undue stress on this furiously pumping muscle. As a woman, you have an increased risk of developing high blood pressure if you are overweight, have a family history of high blood pressure, take certain types of oral contraceptives or have reached menopause. If your blood pressure is above 140/90 mmHg, you should consult your doctor at once. The National Heart, Lung and Blood Institute tells us that even if your blood pressure is normal, you can lower it - and reduce your risk for coronary artery disease.
3. Maintaining a diet rich in fruits and vegetables is not only a heart-health booster, but a cancer fighter as well. According to the National Heart Lung, and Blood Institute, potassium-rich foods (like bananas) seem to prevent high blood pressure. And a recent study of 69,000 women concludes that a fiber-rich diet, especially from breakfast cereals, can also reduce a woman's risk of heart disease.
4. By now everyone is aware of the dangers posed by fatty, high-cholesterol foods - and more than half of all women over age 55 need to lower their cholesterol. But take care not to eliminate fat from your diet altogether. Certain forms of fat actually protect you against fatal heart attacks, scientists have learned. After tracking 76,283 women over 10 years, researchers found that those who consumed oil and vinegar salad dressings - an important source of alpha-linolenic acid, a polyunsaturated fat that protects the heart were less likely to die from heart disease than women who rarely consumed such dressings. Their findings suggest that "fat-free" is not always better - in fact, when you pass on the olive or canola oil, you may be robbing your body of vital heart-helpers. Instead, pass on butter, fatty meats and other saturated fats that can add pounds as well as cholesterol.
5. Nearly every day we hear of new benefits to keeping physically fit. Regular physical activity performed on most days of the week reduces the risk of developing or dying from some of the leading causes of illness and death in the United States, including heart disease. What's more, exercise helps reduce your risk of developing high blood pressure, or to lower your blood pressure if it's already high. Staying active helps you to control your weight and to feel better too. In most people extra pounds lead to higher cholesterol and blood pressure levels. So it's best to keep moving.

How do you know if it's a heart attack?

Don't expect to feel the classic symptoms attributed to male heart attacks: chest pain, pressure, tightness, squeezing, burning or heaviness. Debra R. Judelson, MD, director of the Women's Heart Institute(www.womensheartinstitute.com), tells us that although women may experience these classic signals, they are more likely to complain of shortness-of-breath. If they feel pain, it may be in the abdomen as opposed to the chest, in the back, or even in the jaw or throat. Many times, they simply feel bad but are not sure why. Researchers tell us that women experience heart attacks differently than men because they tend to experience them at an older age, have diabetes and hypertension, and are more likely to be smokers.

Not only are a woman's symptoms different from a man's, so too is her response to them, says Dr. Judelson. Because women do not generally believe they are susceptible to heart attacks, they will frequently ignore signs of illness, thinking nothing is really wrong. Women come to a hospital with a heart attack up to one hour later than a man. When arriving in the emergency room, They are less likely than men to complain of cardiac symptoms and more likely to attribute their symptoms to something else. This delays and seriously impacts their ability to get appropriate emergency care.

That's why if you feel that something is wrong, don't ignore your gut instinct. Seek help as soon as possible instead of waiting to be certain you are really ill.

The good news is that when you do receive prompt treatment, as a woman you are likely to respond better to treatment for heart disease than men do.