can you disarm the risk factors? A heart attack is caused by coronary disease. The coronary arteries carry blood to the heart. When one or more of the four arteries is blocked, a heart attack results.

A healthy lifestyle can help prevent heart disease. This means avoiding controllable risk factors and getting the best care to modify risk factors such as diabetes and high blood pressure.

Risk Factor Control There are many risk factors you can avoid such as smoking, overweight, and lack of physical activity. Cholesterol level is important too. Stop smoking, reducing weight, improving diet and exercising will help lower your blood cholesterol level. If they don't, cholesterol-lowering drugs can help.

Cigarette smoking can actually quadruple a woman's risk of heart disease. But if she stops smoking, her risks drop quickly -- in a matter of months.

Women's cholesterol levels rise after age 55, as do their risk of heart attack. All women should have their cholesterol levels checked annually. Home screening kits are helpful, but they don't break down the total cholesterol score into "good'' and "bad'' cholesterol. It's low-density lipoprotein (LDL) cholesterol -- the "bad'' cholesterol -- that relate increased risk of heart attack. While high levels of high-density lipoprotein (HDL) cholesterol seems to protect the heart. If the total cholesterol level is too high, or the balance between HDL and LDL levels isn't good, some health measures can help.

Avoid animal fats -- use vegetable fats, sparingly. Non-fat foods are great.

Fresh fruits and vegetables, grains, and fish are health choices.

Reduce your weight -- inactivity is a direct risk factor for heart attacks.

the unfit body has an unfit heart that has to work too hard to pump blood to the body. Regular exercise can also reduce cholesterol. Active women have a 50 percent to 60 percent lower risk of heart disease than their inactive sisters.

Hormone replacement therapy (HRT) may be important in reducing risk of heart attack (and other disorders, such as osteoporosis whether or not to take HRT is a decision a woman has to make based on personal risks, family health history, and a doctor's advice.

From the New England Journal of Medicine and the National Heart, Lung and Blood Institute.

J. Lightbourne Chief Nursing Officer HEALTH AND SOCIAL ISSUES HTH