Coronary artery disease is the most common cause of heart disease. These vessels which supply the blood to the heart muscle become hardened and narrowed (atherosclerosis) by the build up of plaque which is a fatty substance that builds up in the presence of too much cholesterol. This causes a decrease in blood and oxygen to the heart causing chest pain (angina) if the decrease blood flow is sufficient the muscle is damaged resulting in a 'heart attack' which can occur without preceding angina / chest pain.

Who is at risk:

Those over 55
Those with a family history of heart disease
Those with an elevated total cholesterol,
Those with an elevated LDL level (low density lipoprotein) or bad cholesterol Which causes plaque to form in the arteries Those with high blood pressure
Smokers (esp. women on birth control pills + smoker = very high risk)
Sedentary life style
Obese
Diabetics

The more risk factors an individual has the greater the likelihood of having a heart attack.

What can you do:

Make the appropriate lifestyle changes: change your diet, exercise, stop smoking, control your weight. Find out if you have high blood pressure or diabetes and get them treated.

Cholesterol testing is a keystone in prevention.

Have your physician start checking your Lipid profile ( total cholesterol, LDL, HDL) at age 45 and every 5 years thereafter, more often if you have risk factors.
HDL (good cholesterol) <40 = high risk >60= low risk
LDL (bad cholesterol) <100 optimal
100-129 above optimal
130-159 borderline high
160-189 high
>190 very high risk

TOTAL Cholesterol <200 desirable
200-239 borderline high
>240 HIGH

Elevated cholesterol can be of dietary origin or a genetic predisposition to make excess cholesterol or both.
Dietary changes are the first step to decreasing cholesterol. Reduce your intake of saturated fats ( animal fats, some vegetable fats, butter, lard, palm oil, and hydrogenated oils). Cheese, milk, and red meats are high in saturated fats.

If an adequate period of appropriate dietary changes does not bring your lipid profile into the normal range, you doctor may suggest medications which lower total cholesterol and LDL while elevating HDL.

In women the rate of heart disease increases with age and after menopause.
It was once thought Hormone Replacement Therapy in menopausal women reduced the incidence of heart disease ' that is no longer believed and may even increase the risk of heart disease.
Women should discuss hormone therapy with their physician to discuss the benefits vs. risks.

Conclusion:

Remember heart disease is as much a threat to women as it is to men.
See your physician check your lipids, blood pressure, blood sugar, body weight (body mass index). Eat a heart healthy diet, stay physically active and maintain a healthy weight.