Know your numbers, because you don't want to become one of this number: 400,000. More than 400,000 women die each year in the United States as a result of cardiovascular disease. It is the number one killer of women of all ethnic backgrounds.

Instead of becoming a statistic, more women need to:

• Know what their blood pressure is and how it compares to the target rate for their age group.
• Know what their cholesterol numbers are, including specifics for LDL, HDL and triglycerides.
• Keep track of their weight and understand what their body mass index (BMI) is and how that impacts their health now and in the future.

MetroHealth medical staff members work closely with patients to develop heart-healthy habits. Success requires commitment. "You have to help yourself and take responsibility to make lifestyle changes to lower your risk for heart disease, even if you are on prescribed medications," says Grace Cater, MD, a cardiologist with the MetroHealth Heart & Vascular Center team. "Every day, ask yourself 'What have I done today to reduce my risk of having a heart attack?'"

Unfortunately, "It seems like we're seeing a lot of younger women with heart issues, women in their 30s and 40s," says Karen Kutoloski, DO, also on the faculty of MetroHealth's Heart & Vascular Center. She says obesity plays a major role in that increase. Obesity has contributed to the increasing number of diabetics in this country, and diabetics are at least twice as likely as others to have heart disease or a stroke.

"It's harder to live a heart-healthy lifestyle in our society than it used to be," says Elizabeth Kaufman, MD, another physician in MetroHealth's Heart & Vascular Center. "We don't have physical activity built into our lives, and there's too much food easily available that isn't good for us."

The three cardiologists agree that lifestyle changes can have a drastic impact on risk factors for heart disease. Tops among those changes:

• Quit smoking.
• Move with purpose. "More exercise is better, but any is good,'' says Dr. Kaufman.
• Consume less animal fat and salt. Use skim milk versions of dairy products. Eat lean meat and poultry and more fish.
• Eat more fruits and vegetables. (See the MetroHealth Healthy Plate for Everyone).
• Release stress. Make room in your life for the things that make you feel good.

"And if there's a family history of heart disease, be especially careful to reduce your other risk factors," says Dr. Kaufman.

When women do have heart problems, "they have different symptoms from men, different kinds of pain," says Dr. Kutoloski. Those symptoms may include jaw or arm pain, shortness of breath, indigestion and excessive fatigue.