WHEN one considers that heart disease is the No. 1 killer of American women, it is difficult to understand the results of a recent study of the American Heart Association (AHA) which showed that the subject of heart disease in women does not come up as often as it should.

Although nearly 95 percent of women who succumb to heart disease have at least one modifiable risk factor, many underestimate such a risk because they are unaware of factors that make one more likely to develop heart disease or that worsen an existing heart condition.

Such modifiable risk factors published in the August 2005 issue of the Mayo Clinic Women’s HEALTHSOURCE include:

1. Smoking
2. High blood cholesterol levels
3. High blood pressure (hypertension)
4. Diabetes
5. Obesity
6. Physical inactivity

Unfortunately, other factors can still put one at risk in spite of lifestyle changes that may improve the abovementioned modifiable risk factors. They include age, gender and family history.

For instance, as one gets older, cholesterol levels and blood pressure typically rise, especially after menopause. Also, high blood pressure and high cholesterol can run in families, putting even those living a healthy lifestyle at greater risk of heart disease.

Since many of the risk factors usually do not cause symptoms, particularly in the early stages, it is important to perform screening tests for certain risks and keep track of results to avoid heart-related problems.

The health letter offers the following key tests:

1. Lipoprotein (lipid profile) - This blood test which is recommended once every five years measures total cholesterol, low-density lipoprotein (LDL) or “bad” cholesterol, high-density lipoprotein (HDL) or “good” cholesterol and triglycerides (another form of fat in the blood). Recommended LDL is 100 milligrams per deciliter (mg/dL) or lower; HDL is above 50 mg/dL.

2. Blood pressure (BP) - Measurement is recommended every two years, or more often if one’s blood pressure is greater than 135/85 millimeters of mercury (mm Hg). A BP of less than 120/80 mm Hg is optimal.

3. Fasting plasma glucose - This blood test checks for diabetes or one’s likelihood of developing the disease. It is recommended every three years, beginning at age 45. An optimal reading is less than 100 mg/dL.

4. Body mass index (BMI) - BMI is a measure of one’s weight in relation to one’s height. Optimal BMI is 19 to 24. Measurement is recommended every two years. To measure BMI, go to www.MayoClinic.com and click on Calculators.

After determining one’s risk factors, a global risk assessment can be completed in order to find out how much of a threat heart disease poses to one’s health.

The risk categories used by the American Heart Association are:

1. High risk - One has conditions such as heart disease, diabetes or a greater than 20 percent risk of having a heart attack in the next 10 years.

2. Intermediate risk - One has two or more heart disease risk factors and a heart attack risk score of 10 percent to 20 percent.

3. Lower risk - The individual has two or more risk factors and a heart attack risk score of less than 10 percent.

4. Optimal - One has optimal levels of risk; the numbers indicate a heart-healthy lifestyle.

Regardless of one’s risk category, heart health can be protected by avoiding tobacco, engaging in regular physical activity (30 minutes on most days), eating a diet low in saturated fat and cholesterol, and achieving and maintaining a healthy weight. In case one has diabetes, high blood pressure or high cholesterol, the doctor may recommend a combination of lifestyle changes with medications to keep the condition under control.

If one is at increased risk or already has heart disease, the doctor may find preventive drug therapy to be beneficial, using aspirin, ACE inhibitors, beta blockers and statins.

Since heart disease is the No. 1 killer of American women and almost 95 percent of those who die of the condition have at least one modifiable risk factor, screening tests should be done in order to determine an individual’s risk factors, estimate the 10-year chance of having a heart attack, and find out one’s risk category.

Thus, a heart disease prevention or an appropriate treatment plan can be developed with one’s doctor, reducing one’s chances of unexpected heart-related problems in the years ahead.