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Heart disease was once considered by many to be a disease that afflicted primarily men. But that thinking is now obsolete.

In fact, heart disease is the leading cause of death for women (as well as men), killing one in four and taking more lives than all forms of cancer combined, according to statistics compiled by the American Heart Association and Centers for Disease Control. And more than one in three women suffer from some form of cardiovascular disease.

Yet, heart disease is not often put at the forefront of women’s health topics.

“A lot of attention is focused on things like breast cancer … and those things are very important, it’s true,” said Dr. Ian Riddock, a cardiologist for Bend Memorial Clinic. But, he added, sometimes potential heart issues are ignored, despite the availability and ease of screening tests.

Women do have a longer life expectancy overall, 81.2 years for women compared with 76.4 years for men, according to the latest CDC data. That gives most women about a 10-year head start when it comes to developing heart disease, Riddock explained.

But while men do have a greater risk of heart disease than premenopausal women, once past menopause, a woman’s risk roughly equals a man’s.

“That’s when women start to catch up,” said Dr. Bruce McLellan, cardiologist at St. Charles Medical Center’s Heart and Lung Center. “And we don’t know entirely why (postmenopausal risk rises).”

Once past menopause, women share many of the same risk factors as men.

Like men, women’s family history (particularly immediate family) of heart disease is the most important indicator of elevated risk, McLellan and Riddock agreed. High blood pressure, diabetes and high cholesterol are also strong indicators of elevated risk.

At particular risk are those with metabolic syndrome — which combines a dangerous cocktail of increased abdominal fat, high blood pressure, high triglycerides, low high-density lipoprotein cholesterol (HDL, or good cholesterol), and impaired fasting blood sugar.

The atherogenic dyslipidemia triad — a combination of high triglycerides, low levels of HDL, and often normal levels of lipoprotein cholesterol (LDL, or bad cholesterol), but higher prevalence of small, dense particles that traffic the LDL — also signals elevated risk for cardiovascular disease.

“Most of your average risk calculators that we conventionally use, women are always going to be at a low risk,” said Riddock, adding that is a product of women’s longer life expectancy. “A lot of women are low risk, but there is a significant subpopulation that is at a higher risk.”

One problem with heart disease is that it presents itself in three primary ways: angina, heart attack or sudden death, said McLellan.

That makes early detection the key.

“None of those are good, some are obviously worse than others,” he said. “Let’s say you’re lucky and you get angina, and we have good medicines, stents and bypass surgery, but you’re now on the road of a disease that is like a slow-growing cancer. We’re never going to get rid of it, never going to stop it, we just hope to slow it enough to get you through your life without any more events.”

McLellan suggests at around age 50 women should get a coronary calcium scan, a CT scan that detects specks of calcium on the coronary arteries.

Calcification is an early sign of coronary heart disease and among the best predictors of heart attacks.

“If you’re developing aggressive plaque, then it’s time to start treating the cholesterol aggressively,” McLellan said.

But perhaps the most effective measure against heart disease is prevention. In fact, much of what we consider common-sense health choices are the most effective ways to combat the onset of heart disease.

“Good exercise, diet and (not smoking) cigarettes are all things you can do to affect your own health,” McLellan said. “Some of those will also affect whether you are going to get high blood pressure and diabetes. Starting an exercise program and making weight control a primary goal can make a tremendous downstream difference in your health.”

Simple choices such as eating a healthy diet (McLellan suggests that the largely plant-based mediterranean diet is particularly heart healthy), regular exercise and abstaining from risky behavior such as smoking and heavy drinking can all make significant inroads.

In addition, such choices can also help slow or even reverse metabolic syndrome or atherogenic dyslipidemia.

“The lesson is that A, we can prevent heart disease from ever manifesting into those bad complications, like heart attack and death,” Riddock said. “But B, we could potentially reverse these things. That’s why it is so important to recognize it.”