As in the majority of westernised cultures, heart disease is the number one killer in Bermuda. So although this is a topic I?ve covered before, let?s revisit it to make sure we all know our risks ? and what we can do about them. If you?re under 30 and about to put this down ? because, hey, heart disease is for old people! ? think again. Emergency rooms across the world are seeing an increasing incidence of cardiac events in younger generations. Don?t think that this is irrelevant for you ? it?s actually relevant for everyone.

Another common misconception is this: That heart disease is a man?s disease.

This is understandable as many more men have sudden ? and very dramatic ? heart attacks. It?s these shocking incidents that have come to define heart disease for so many people. But the truth of it is this ? women are almost as vulnerable. Although we grow up under the shadow of a much more gender specific disease, breast cancer, we are actually ten times more likely to die from heart disease. Ten timesDoes this mean we should stop worrying about breast cancer? Of course not. But what it does mean is that we need to alert women in Bermuda to their cardiac risk.

Luckily, the Bermuda Heart Foundation is up for this task! Myrian Balitian-Dill, the head cardiac nurse at KEMH and a founding member of the BHF is currently delivering a series of ?lunch and learns? at workplaces around the Island. Myrian was in our office today and gave a brilliantly informative seminar. It was a fun session, but scary too. She shared some frightening statistics including over 500,000 women die of heart disease each year in the US. That means, for every minute that you are reading this, working, or cooking dinner at home, one woman in the US will die of heart disease. Every hour of every day.

The likelihood of a woman living within our kind of culture, dying from heart disease, currently stands at 31 percent. Although a woman?s incidence of heart disease is not quite as high as a man?s, we?re catching up. In many ways, this is a new battle of the sexes. Because what?s worrying is not just that our incidence is catching up with men, but that once we are in hospital after a heart attack, once we?ve had our surgery or even when we?re recovering at home, we are more likely to die than a man. Despite major improvements in heart disease mortality rates over the last 20 years, there have been no improvements in women?s outcomes. Why? Myrian suggests this is largely because women aren?t aware of the severity of their risk. Women don?t know they should be preventing heart disease, they don?t know what the symptoms feel like, they don?t know what questions they should be asking their GPs.

So what can you do? The first thing is that as a woman, you need to make sure you have all the information available to you regarding heart disease. Ask your employer to organise a lunch and learn with Myrian! As a man, make sure that the women in your life are aware of their risks and this educational opportunity ? whilst not forgetting your own risk too, of course. Secondly, whether you are young, older, male or female, we all need to be eating a heart-healthy diet and living a healthy lifestyle. See below for 12 steps you can take right now!

Before I sign off for this week, many of you will have seen an e-mail that is circulating at the moment. It goes like this: ?Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body, but rather to skid in sideways, chocolate in one hand, wine in the other, body thoroughly used up, totally worn out and screaming ?WOO HOO what a ride!?

In many ways I couldn?t agree more! It?s very funny and has such a legitimate seize the day philosophy. But when it comes to heart disease, you have to consider this.

I?m not just talking about extending your life, but improving your quality of life. Heart disease often goes hand in hand with breathing difficulties, impotence and intense chest pains ? not to mention the fear that that every little pain could lead to something altogether more serious.

So you?ll only skid through heaven?s gates with a glass of sauvignon blanc in your hand and a mischievous smile on your face if you were enjoying the life you were living in the first place! With this in mind, over the next three weeks I?m going to tackle certain aspects of heart disease in more detail: cholesterol, blood pressure and something called homocysteine. Be sure you check in every Friday to keep your healthy heart know-how up to date.

Saturated fats cause the blood to become thick and sticky, encouraging the formation of clots that can block arteries. Avoid saturated, hydrogenated and trans fats ? such as those found in fried foods (e.g. KFC, chips), margarines, cookies, full fat dairy produce, red meat, cakes, pastries and creamy sauces.

Oily fish, such as mackerel, salmon, tuna and sardines have a very high Omega 3 ?good fat? content. Omega 3 has been shown to help thin the blood (reducing blood pressure), increase good HDL cholesterol and lower bad LDL cholesterol. Aim to eat oily fish at least three times a week (baked or grilled, not fried) or consider supplementing Omega 3. However, please consult your GP before supplementing your diet with Omega 3 oils as some medical conditions (e.g. epilepsy) and drugs (e.g. blood thinners such as Warfarin) are contraindicated with Omega 3.

The apparently logical supposition that cholesterol rich foods actually contribute to high blood cholesterol, is actually a theory that?s under debate ? more on this next week! However, to be safe, go easy on foods that are naturally high in cholesterol ? including shrimp, meat, eggs and full fat dairy produce. LDL cholesterol deposited on artery walls is bad enough, but oxidized cholesterol is even worse as it is more difficult for the body to remove.

Cigarette smoke, fried foods and pollution all oxidize cholesterol. So if you do smoke, it is vital that you give up. However antioxidants found in fruits and vegetables do help to protect cholesterol from oxidation.

Vitamin C has been shown to inhibit excessive cholesterol production and to maintain elasticity of blood vessels. Yellow peppers, blueberries, strawberries, broccoli, oranges and papaya are all rich in vitamin C. You may also choose to supplement vitamin C ? try starting with 500mg daily, but if you have any health conditions or are on any medications, do check with your doctor first.

Your heart and arteries are surrounded by a layer of muscle. Too much sodium can increase the pressure from these muscles, which in turn increases blood pressure. Whilst we all do need some sodium, nobody needs to add salt to their food, there is enough sodium present naturally in our foods.

These foods are all rich in calcium, magnesium and potassium ? all important for controlling blood pressure, but magnesium is most important. A severe magnesium deficiency can actually cause a heart attack in the absence of any arterial blockage, as it can result in cramping of a coronary artery. These foods are also rich in B6, B12 and Folic Acid and are vital for the safe conversion of a substance called homocysteine in the blood. Excess homocysteine can create lesions on artery walls which attract the deposit of atherosclerotic plaque. More on homocysteine later on this month!

Fiber reduces LDL (bad) cholesterol as it binds with bile salts and causes them to be excreted from the digestive tract. Bile salts are vital for digestion and are made using LDL cholesterol, so the body will divert LDL cholesterol away from the artery walls and into the digestive system in order to make more bile salts. Wholegrain oats and apples are particularly good at helping to remove excess cholesterol from the body.

Some studies do suggest that a moderate alcohol intake actually helps to prevent heart disease, but this is currently under debate. However, there is certainly some evidence to suggest that the bioflavonoid content of red wine has beneficial antioxidant properties.

Men are generally advised to restrict their intake to two glasses of red wine daily and women are advised to restrict their intake to one glass daily. However if you currently have any health concerns, please consult your doctor for a personal recommendation.

Whilst statins block the enzymes that make cholesterol, they also prevent the manufacture of CoQ10 ? an antioxidant nutrient that is vital for a healthy heart. However, always consult your GP prior to taking any supplement in conjunction with medication.

Being overweight is another risk factor for heart disease as the excess weight puts too much pressure on your heart. However, even if you are on target, exercise is still crucial for a healthy heart ? for example, it helps to improve circulation and reduces both cholesterol and blood pressure.

Stress always exacerbates any health condition, but is especially harmful to those with heart disease as it causes an increase in blood pressure. Try relaxing forms of exercise (Yoga, Tai Chi, Qigong, Pilates, walking), massage and meditation.

If you are over 30, make sure you go for your annual physical. Don?t fall into the trap of thinking that ?ignorance is bliss? ? it?s much easier to deal with a minor problem early on, than to deal with a major problem at a later stage.