This information should not be used as a substitute for a doctor's care. Please consult with your doctor before changing or adding any therapies.

Sometimes, when I can't fall asleep, I count the beats of my heart. Tha-thump, tha-thump, tha-thump, I search for the steady rhythm. Tha-thump, I hear the beat through my inner ear. Tha-thump, it pushes to my fingertips. Tha-thump, I try to slow it down. Tha-thump, my breath and heart in sync, tha-thump, and I'm asleep.

Everyone eventually dies of heart failure, a doctor once told me. Regardless of what else might be killing you, when your heart stops, that's it. Culture sees the heart as the seat of emotion, it symbolizes our courage, and it breaks like glass. Metaphors aside, the heart is a muscle with a job to do. It doesn't require our conscious effort to work, and for most of us, we take it for granted right up until the time it stops working well.

Heart disease is the No. 1 cause of death in the United States, accounting for 26.8 percent of all deaths in 2006. In Mississippi, the rate is even higher: 28.3 percent, according to the Centers for Disease Control in Atlanta. Women have a higher risk for heart disease than men, it turns out, although we are frequently misdiagnosed because our symptoms can be dramatically different.

Risk factors for heart disease include everything from genetics to obesity to
poor lifestyle choices like being sedentary and smoking.

"Based on early studies, smoking was recognized as a bad practice for lung cancer, emphysema, and chronic bronchitis, [but] … it's an even bigger problem for cardiovascular disease," said Dr. William Kannel, former director of the Framingham Heart Study in a 2007 PBS interview. "… [T]here are at least 10 cardiovascular events for every case of lung cancer (attributed to smoking)."

The groundbreaking Framingham Heart Study, which has been ongoing since 1948, has followed more than 10,000 participants to identify the causes and risk factors for heart disease and stroke. Many of the facts about heart disease that we take for granted today, like the connection between high cholesterol and heart attacks, come from the study, which is now working with the children and grandchildren of the original set of subjects.

Before the study "there was a concept that (heart disease) was an inevitable (result) of aging and genetic makeup; that if you had a bad family history, that was it," Kannel says. "We began to say, ‘No, it isn't exactly that way; some folks are more susceptible than others, and there are correctable, predisposing causes that can be dealt with to lower the risk.' This was an important contribution."

Like any muscle, your heart responds to conditioning. Regular exercise is one of the best ways to keep your heart in shape. As you become more fit, your heart doesn't have to work as hard to pump blood through your system. Controlling high blood pressure is also important, as is keeping your cholesterol in check.

Exercise is also a great stress reliever, which is important because doctors are discovering that stress plays a huge role in whether your heart is healthy. Cardiologist Dr. John Kennedy, author of "The 15-Minute Heart Cure," (Wiley, 2010, $25.95) and board member of the American Heart Association, says stress is often the underlying cause of heart disease.

"The reason that this is so is because when the ‘flight or fight response' is triggered, adrenal and cortisol are released into the body and have deleterious effects on the heart, the blood pressure, inflammation, and so on," Kennedy told PsychCentral.com. "I give talks to doctors, and of the last 3,000 of them I asked if emotional stress precipitates heart disease; well, 3,000 out of 3,000 agree."

Kennedy's book uses guided imagery and breathing techniques to induce the relaxation response, something people who meditate or practice yoga can appreciate.

"I actually based it on sports psychology, meditation techniques and cognitive behavioral therapy," Kennedy says.

"The technique can be used in business as well. You know, in other cultures, Italy for example, people work to live. Here in America, we live to work. … [W]e all need to downshift and be in the moment."

Other activities that can lead to a healthy heart include simple things like laughter and listening to joyful music, according to cardiologist Dr. Michael Miller, director of preventive cardiology at the University of Maryland Medical Center in Baltimore. His study on music showed a 26 percent increase in blood-vessel dilation (that's good) when subjects listened to joyful music that they liked.

"The (positive) responses we've seen to music and laughter are similar to those that are obtained with exercise or the use of medications that are protective to the heart, such as statins," Miller says in a hospital interview. "… Clearly, they should be considered as part of our heart-healthy routine lifestyle.

Hungry Heart
Julia Zumpano, a dietitian with the Preventive Cardiology Center at The Cleveland Clinic, recommends a "whole-foods diet" for heart health. "You want everything to be in its natural form, as it comes from the ground, the less processed the better," she says on WebMD.

The following are WebMD's top 10 recommendations for heart-healthy eating. For the complete list of 25, including a list of nutrients provided by each food and serving suggestions, go to http://www.webmd.com/food-recipes/features/25-top-heart-healthy-foods.

1. Salmon
2. Flaxseed (ground)
3. Oatmeal
4. Black or Kidney Beans
5. Almonds
6. Walnuts
7. Red wine
8. Tuna
9. Tofu
10. Brown rice

It's Different for Girls
Doctors often misdiagnose heart attacks in women because their symptoms aren't necessarily the same as those for men. In general, heart attack symptoms can include:
• Shortness of breath.
• Repeated episodes of chest discomfort.
• Discomfort in other parts of the upper body, such as one or both arms (usually the left), the back, left shoulder, neck, jaw, or stomach
• Numbness or tingling in the arm, hand or jaw.
• Dizziness or light-headedness.
• Sweating.

Women are less likely to have chest pain during a heart attack, and their symptoms can also include:
• Back, neck or jaw pain
• Persistent heartburn or indigestion
• Nausea or vomiting
• Dizziness or light-headedness
• Weakness
• Fatigue

SOURCE: http://www.pbs.org/takeonestep/heart.