By Elizabeth DeVita-Raeburn, Women's Health
Willard Scott began wishing centenarians happy birthday on the air more than two decades ago, and it's taking him longer and longer to get through his stack of mail — the number of nominees has grown from a handful in 1983 to 400 a week these days. There's no doubt about it: Americans are living longer. Since 1900, life expectancy has increased from 48 to 80 years for U.S. women (from 46 to 75 for men). And the Census Bureau predicts that by 2050, the number of Americans over 100 will quadruple. This means not only a bigger boom for Florida real estate but that you, dear reader, are 10 times more likely than your grandparents to live tosee triple digits.
Which is both exciting and scary. When we surveyed our readers, only 12 percent of you said you even want to live to 100. One likely reason: You don't want to be a sick, feeble old lady. No argument there. Americans' biggest worry about getting older is declining health, according to a Parade/Research America poll. "Twenty years ago, most people thought living to 70 meant you'd be frail and decrepit, because that was the truth," says Michael Roizen, M.D., author of RealAge: Are You as Young as You Can Be? But iPods and BlackBerries weren't around 20 years ago either. Medical research has evolved right alongside everything else we never could have imagined and dramatically changed our outlook on longevity. "The knowledge of prevention and our understanding of how to control our genes have progressed so much that by the time today's 60-year-olds reach 100, their quality of life won't have declined much at all," Dr. Roizen says. Imagine living 10 decades but having Jane Fonda's figure (hey, she's only 69) or doing yoga moves like 48-year-old Madonna.
You can take simple measures right now to give Father Time the finger. Add to that the radical medical breakthroughs that will come about in the next decade and you'll be playing Demi to your Ashton until trucker hats come back in style. We can't promise that Willard will be around to wish you a happy birthday by the time you're planning your 100th b-day bash but with our guide on how to stay young, you'll be too busy partying to notice.
Your Brain
Even if you never made a cameo in a Girls Gone Wild video, chances are you've sown a few wild oats (or hops and barley) and fried a couple million brain cells along the way. But before you worry too much about your habit of losing your keys, know that you're not doomed to senility.
Aging and factors like stress, lack of sleep, depression, and alcohol intake gums up the gears, making it harder for brain cells to function quickly and effectively, says Mark Mattson, Ph.D., chief of the laboratory of neurosciences at the National Institute on Aging. Assaults on your brain cells increase the odds that the proteins that cause dementia will build up. But this isn't as grim as it sounds. "The brain naturally slows down with age," says Pierce J. Howard, Ph.D., author of The Owner's Manual for the Brain. "But the memories are still there."
Undoing the damage can be as simple as exercising and drinking lots of water to rehydrate cells dried out from caffeine and alcohol, Dr.Howard says. Research has shown that moderate exercise elevating your heart rate for 20 minutes three or four times a week bolsters brain cells. Adopting a reduced-calorie diet does too. Both regimens act as mild stressors, and nerve cells respond to stress by becoming more resistant (think of how your hands form calluses). Stress of this sort also acts like a kind of natural steroid for the mind, sparking nerve growth factors (proteins that enable brain cells to convey information) that have been shown to improve memory.Researchers have proved that the same "use it or lose it" rule that works for your abs also applies to your brain. Simply filling in a crossword puzzle or reading every day is the equivalent of crunches. Instead of creating a six-pack, you're forming strong connections between cells that transmit thoughts. "No matter your age, mental exercise has a positive effect on your brain," says Daniel Amen, M.D., author of Making a Good Brain Great. In one study of 800 old folks, subjects read the newspaper or engaged in other mentally stimulating activities. After 5 years, those who increased mental activity reversed some of their age-related memory decline and were less likely to develop Alzheimer's.
Even the guy from Memento could benefit from the leaps made in treating serious memory loss and dementia. For example, scientists are working on an Alzheimer's vaccine. Japanese researchers recently vaccinated mice bred to develop the disease and found that they had up toa 38 percent reduction in the degenerative proteins thatcontribute to Alzheimer's. Scientists predict that such a vaccine to manage Alzheimer's symptoms will be available for people in 6 or 7 years.
There's progress being made on a memory drug as well: A few years ago, neuroscientist Tim Tully, Ph.D., enhanced a gene in fruit flies and created the insect equivalent of photographic memory. The gene, called CREB, cements new learning and experience into long-term memories. And before you say "fly, schmy," you should know that humans have the CREB gene too. Right now, some 40 companies are in the race to develop the first memory-boosting pill which they expect to have within a decade.
Your Eyes
What's the use of having a good head on your shoulders in the year 2076 if you can't see well enough to enjoy virtual reality PlayStation — ora Clive Owen simulator? There's plenty you can do to protect your baby blues, browns, greens, or hazels. This magazine has "health" in the title, so you don't need to be told that lighting up is a bad thing. Then againmaybe it bears repeating: Ditching a smoking habit is one of the best things you can do for your vision. That's because cigarette smoke increases the risk of cataracts, macular degeneration (more on this in a minute), and the nerve damage that leads to glaucoma, says Sandra Cremers, M.D., professor of ophthalmology at Harvard Medical School. Wearing shades is another must because UV light harms the lenses of your eyes.
Aside from the risk of catching a glimpse of Michael Douglas naked, the biggest threat age poses to your sight is macular degeneration. It's the leading cause of blindness in people over 55. If you dozed through Bio 101, here's a review: The back of your eye is called the retina, and it is responsible for converting light into messages your brain understands. The center of your retina is the macula, which contains the largest number of light-detecting cells. No one knows why, but over time, the macula loses its sensitivity, and your vision dims with it. When the macula no longer senses light properly, you can forget reading, driving, or watching reruns of Lost (though it probably won't make any more sense in 50 years than it does now).
A tiny artificial retina, however, could keep everyone seeing the light. Researchers are fine-tuning a chip the size of a pinhead that contains about 3,500 microscopic solar cells. Once implanted in the back of the eye, the chip would be able to process light in much the same way that our retinas do. With any luck, those scientists will explain what's happening on Lost, too.
Your Ears
You probably haven't thought about your hearing much since those grade-school beep tests. But a lot's been going on in your ears since then — aside from wax manufacturing. If you magnified the inner ear about a million times, it would look like a dense forest of 20,000 trees. Those "trees" are microscopic hairlike cells that pick up vibrations from the outside world, convert them to electrical impulses, and zip them to your brain for translation. Over time, some trees dry up and die, while others are irreparably damaged by what you might call rowdy campers — aka noise. ALollapalooza or two permanently wipes out a couple of acres of inner-ear cells. In fact, a full 40 percent of the destruction of these cells in a person's lifetime is due not to age but to noise exposure, says Sergei Kochkin, Ph.D., director of the House Hearing Institute in Alexandria, Virginia.
You don't need a green thumb to save your ear forest. Instead, keep your iPod below 60 percent of its maximum volume and take a break every 20 or 30 minutes to let your ears rest. The sensory cells will repair themselves if given at least 24 hours to recuperate from minor damage, like a Beastie Boys concert, says Sig Soli, Ph.D., head of the department of communication sciences and devices at the Better Ear Institute in Los Angeles. And if you've already logged hundreds of hours with the volume at 11, there's a pill that might put your hearing levels back in check.
That pill is based on an amino acid called n-acetylcysteine that naval researchers are studying. N-acetylcysteine helps stimulate the production of a protein, glutathione, that acts like a park ranger for the hairlike cells. Glutathione absorbs a toxin that attacks the sound receptors as a result of noise overload. Sold as a supplement, the Hearing Pill is currently available ($35, American BioHealth Group) but not FDA approved (supplements aren't subject to FDA regulation). Additional testing is under way to pinpoint just how effective these pills are.
The coolest research of all involves reversing hearing loss by growing new sensory cells. Researchers at the Kresge Hearing Research Institute in Ann Arbor, Michigan, stimulated new cell growth with gene therapy in deaf guinea pigs. Within our lifetime, experts say, we might be able to grow new ear cells just as fast as we lose them — a huge bummer to hearing-aid makers everywhere.
Your Breasts
Anyone who's spent time in a ladies' locker room has seen the disheartening effects time can have on the girls. What's even more disturbing is that our chances of getting breast cancer go up as we age. One culprit is the burst of estrogen and progestin released monthly during ovulation to stimulate the cells lining the milk ducts to multiply. Over time, cells can make mistakes. "The more times cells divide and reproduce their genetic information, the more likely it is you'll start to see some genetic accidents," says Christy Russell, M.D., chair of the American Cancer Society's breast cancer advisory group.
A good sports bra supports your breasts in more ways than one — assuming you're actually exercising in it. Scientists have proven over and over that even moderate activity — roughly 2 hours of exercise a week — can reduce a woman's risk of breast cancer by 20 percent. One reason may be that your ovaries produce slightly lower levels of hormones when you're regularly working out, Dr. Russell explains, reducing the amount of estrogen and progestin sent to your breasts.Aside from following all the obvious health rules (don't smoke, keep your weight in check, don't overindulge in alcohol, etc.), your best measure is to stay vigilant with your gyno checkups. Should something troubling appear, early detection can make all the difference. According to the National Breast Cancer Foundation, there is a 96 percent survival rate when breast cancer is found early.
That's why some rapidly developing advances in mammography are so important. Digital mammograms (as opposed to standard x-ray film versions) and MRIs for breast screening have made leaps in recent years, offering clearer images and more accurate readings. They will be more widely available — and more affordable — as they improve. Another screening method showing promise is called MR spectroscopy. Through an MRI machine, a technician uses a computer program that bounces radio waves off suspicious cells to decipher their chemical composition, says Lia Bartella, M.D., assistant professor in the department of breast imaging at Memorial Sloan-Kettering Hospital in New York City. These images can show whether a tumor is benign or malignant without requiring a biopsy. "This can prevent 58 percent of women from undergoing unnecessary biopsies," Dr. Bartella says. She expects thetechnology to take hold inthe next 5 years.
Further down the road, mammograms and breast scans may become things of the past. Scientists are developing a diagnostic blood test much like the one now used to detect prostate cancer. The test would find the proteins made by cancer cells long before a tumor is large enough to be discovered any other way. "Ten years from now, a woman might be able to have a breast cancer profile done along with her cholesterol test," says Christine Laronga, M.D., associate professor of surgery at the Moffitt Cancer Center at the University of South Florida in Tampa.
And if the docs do find a tumor, in the next 10 years they'll have much smarter tools to help them get rid of it. The American Society of Breast Surgeons recently endorsed a procedure called accelerated partial breast irradiation (APBI). Instead of bombarding a patient with radiation all over the breast, doctors can now deliver it to just the trouble spot. Because less of the body is affected, higher doses can be given, so treatment takes only 5 days instead of 6 weeks. Another development to watch: radiofrequency ablation. Commonly used on liver tumors, it destroys the tumor with electric current and ultrasound rather than hugely invasive surgery. Two major cancer centers are currently studying its potential use on breast cancer.
Your Heart
It's easy to write off heart trouble as something that plagues only cheeseburger-inhaling ex-presidents. But cardiovascular disease is a huge concern for women — it's our number one killer. As we age, blood vessels lose flexibility, and cholesterol causes layers of plaque to pile up. This means the heart has to work harder to pump blood, so your blood pressure climbs. "Women who haven't been to the doctor in years often think they've suddenly developed high blood pressure," says Nieca Goldberg, M.D., chief of women's cardiac care at Lenox Hill Hospital in New York City and the author of The Women's Healthy Heart Program. "But really, it's been happening for years."
One solution likely to surface in the next 10 years is much higher definition CT scans, says Andy Kessler, a technology analyst and the author of The End of Medicine. "These scans will be able to find arteriosclerosis [the hardening and blockage of arteries] in women earlier, so fewer will die of heart attacks and strokes," Kessler says.If you've got high cholesterol (anything above 240), a precursor of heart disease, doctors currently prescribe statins such as Crestor, Lipitor, or Zocor. These drugs inhibit the liver's ability to produce LDL cholesterol (the bad kind). More effective drugs, called CETP (cholesterol ester transfer protein) inhibitors, will be available in the next couple of years. CETP inhibitors prevent the production of a protein that turns HDL cholesterol (the kind that actually removes existing cholesterol from artery walls) into LDL cholesterol, its evil twin. One CETP inhibitor, torcetrapib, may get FDA approval as early as next year, and more are in the works. Meanwhile, Avant Pharmaceuticals has a vaccine in development with the same HDL-boosting effect as the CETP inhibitors.
But drugs don't have to be the answer. "You can reduce your risk of heart disease by 82 percent with simple lifestyle changes," says Jennifer Mieres, M.D., director of nuclear cardiology at New York University Medical Center. Exercise (30 minutes of aerobic activity four times a week) improves the flexibility of your blood vessels. And a low-fat diet reduces the amount of fat that lines them.
Your Skeleton
By your 30th birthday you've reached peak bone mass, says Ethel Siris, M.D., director of the Tony Stabile Center for the Prevention and Treatment of Osteoporosis at NewYork-Presbyterian Hospital. At that point, you're still building bone, but your body is breaking down the existing bone faster than you can replace it. After age 35 or so, the average woman loses between 0.3 and 0.5 percent of her bone density per year. This loss, if left unchecked, will result in the porous, brittle bones that come with osteoporosis — and that trademark hunchback. Half of women over 50 will suffer an osteoporosis-related fracture at some point. Without preventive measures, you'll be at risk for acting out one of those I've-fallen-and-Ican't-get-up commercials.
But you can still protect your bones. Like muscles, bones get stronger when you use them — through weight training, aerobic exercise, even walking. "Bone responds to stress by getting harder," explains Kirby Hitt, M.D., an orthopedic surgeon and director of Adult Reconstructive Surgery at Scott & White Hospital in Temple, Texas. (See page 112 for workouts to keep your bones strong.)
While bionic limbs probably won't be on the market for grannies anytime soon, researchers are on the trail of some truly stranger-than-fiction methods for repairing and replacing bone. A team at the University of Michigan has discovered a gene that stimulates bone growth. And a group at Vanderbilt University in Nashville is planning human trials on a technique in which they transplant new cells grown from a healthy portion of bone to a part of the body where they're needed. Other research involves repairing cartilage and bone with hyaluronan, a lubricating substance naturally found in the joints. But it will likely be at least 10 years before any of these treatments become widely available.
Much closer to market is a bone-bolstering drug called denosumab. Injections of the substance seem to inhibit the protein that promotes bone deterioration, and several studies have shown its potential for alleviating the effects of osteoporosis, arthritis, and bone cancer. So drink your milk, do your reps, and know that with a little help from science, you'll be hiking, biking, swimming, and doing all the things you love to do — from now until at least 2076.
— With additional reporting by Jane Di Leo
Which is both exciting and scary. When we surveyed our readers, only 12 percent of you said you even want to live to 100. One likely reason: You don't want to be a sick, feeble old lady. No argument there. Americans' biggest worry about getting older is declining health, according to a Parade/Research America poll. "Twenty years ago, most people thought living to 70 meant you'd be frail and decrepit, because that was the truth," says Michael Roizen, M.D., author of RealAge: Are You as Young as You Can Be? But iPods and BlackBerries weren't around 20 years ago either. Medical research has evolved right alongside everything else we never could have imagined and dramatically changed our outlook on longevity. "The knowledge of prevention and our understanding of how to control our genes have progressed so much that by the time today's 60-year-olds reach 100, their quality of life won't have declined much at all," Dr. Roizen says. Imagine living 10 decades but having Jane Fonda's figure (hey, she's only 69) or doing yoga moves like 48-year-old Madonna.
You can take simple measures right now to give Father Time the finger. Add to that the radical medical breakthroughs that will come about in the next decade and you'll be playing Demi to your Ashton until trucker hats come back in style. We can't promise that Willard will be around to wish you a happy birthday by the time you're planning your 100th b-day bash but with our guide on how to stay young, you'll be too busy partying to notice.
Your Brain
Even if you never made a cameo in a Girls Gone Wild video, chances are you've sown a few wild oats (or hops and barley) and fried a couple million brain cells along the way. But before you worry too much about your habit of losing your keys, know that you're not doomed to senility.
Aging and factors like stress, lack of sleep, depression, and alcohol intake gums up the gears, making it harder for brain cells to function quickly and effectively, says Mark Mattson, Ph.D., chief of the laboratory of neurosciences at the National Institute on Aging. Assaults on your brain cells increase the odds that the proteins that cause dementia will build up. But this isn't as grim as it sounds. "The brain naturally slows down with age," says Pierce J. Howard, Ph.D., author of The Owner's Manual for the Brain. "But the memories are still there."
Undoing the damage can be as simple as exercising and drinking lots of water to rehydrate cells dried out from caffeine and alcohol, Dr.Howard says. Research has shown that moderate exercise elevating your heart rate for 20 minutes three or four times a week bolsters brain cells. Adopting a reduced-calorie diet does too. Both regimens act as mild stressors, and nerve cells respond to stress by becoming more resistant (think of how your hands form calluses). Stress of this sort also acts like a kind of natural steroid for the mind, sparking nerve growth factors (proteins that enable brain cells to convey information) that have been shown to improve memory.Researchers have proved that the same "use it or lose it" rule that works for your abs also applies to your brain. Simply filling in a crossword puzzle or reading every day is the equivalent of crunches. Instead of creating a six-pack, you're forming strong connections between cells that transmit thoughts. "No matter your age, mental exercise has a positive effect on your brain," says Daniel Amen, M.D., author of Making a Good Brain Great. In one study of 800 old folks, subjects read the newspaper or engaged in other mentally stimulating activities. After 5 years, those who increased mental activity reversed some of their age-related memory decline and were less likely to develop Alzheimer's.
Even the guy from Memento could benefit from the leaps made in treating serious memory loss and dementia. For example, scientists are working on an Alzheimer's vaccine. Japanese researchers recently vaccinated mice bred to develop the disease and found that they had up toa 38 percent reduction in the degenerative proteins thatcontribute to Alzheimer's. Scientists predict that such a vaccine to manage Alzheimer's symptoms will be available for people in 6 or 7 years.
There's progress being made on a memory drug as well: A few years ago, neuroscientist Tim Tully, Ph.D., enhanced a gene in fruit flies and created the insect equivalent of photographic memory. The gene, called CREB, cements new learning and experience into long-term memories. And before you say "fly, schmy," you should know that humans have the CREB gene too. Right now, some 40 companies are in the race to develop the first memory-boosting pill which they expect to have within a decade.
Your Eyes
What's the use of having a good head on your shoulders in the year 2076 if you can't see well enough to enjoy virtual reality PlayStation — ora Clive Owen simulator? There's plenty you can do to protect your baby blues, browns, greens, or hazels. This magazine has "health" in the title, so you don't need to be told that lighting up is a bad thing. Then againmaybe it bears repeating: Ditching a smoking habit is one of the best things you can do for your vision. That's because cigarette smoke increases the risk of cataracts, macular degeneration (more on this in a minute), and the nerve damage that leads to glaucoma, says Sandra Cremers, M.D., professor of ophthalmology at Harvard Medical School. Wearing shades is another must because UV light harms the lenses of your eyes.
Aside from the risk of catching a glimpse of Michael Douglas naked, the biggest threat age poses to your sight is macular degeneration. It's the leading cause of blindness in people over 55. If you dozed through Bio 101, here's a review: The back of your eye is called the retina, and it is responsible for converting light into messages your brain understands. The center of your retina is the macula, which contains the largest number of light-detecting cells. No one knows why, but over time, the macula loses its sensitivity, and your vision dims with it. When the macula no longer senses light properly, you can forget reading, driving, or watching reruns of Lost (though it probably won't make any more sense in 50 years than it does now).
A tiny artificial retina, however, could keep everyone seeing the light. Researchers are fine-tuning a chip the size of a pinhead that contains about 3,500 microscopic solar cells. Once implanted in the back of the eye, the chip would be able to process light in much the same way that our retinas do. With any luck, those scientists will explain what's happening on Lost, too.
Your Ears
You probably haven't thought about your hearing much since those grade-school beep tests. But a lot's been going on in your ears since then — aside from wax manufacturing. If you magnified the inner ear about a million times, it would look like a dense forest of 20,000 trees. Those "trees" are microscopic hairlike cells that pick up vibrations from the outside world, convert them to electrical impulses, and zip them to your brain for translation. Over time, some trees dry up and die, while others are irreparably damaged by what you might call rowdy campers — aka noise. ALollapalooza or two permanently wipes out a couple of acres of inner-ear cells. In fact, a full 40 percent of the destruction of these cells in a person's lifetime is due not to age but to noise exposure, says Sergei Kochkin, Ph.D., director of the House Hearing Institute in Alexandria, Virginia.
You don't need a green thumb to save your ear forest. Instead, keep your iPod below 60 percent of its maximum volume and take a break every 20 or 30 minutes to let your ears rest. The sensory cells will repair themselves if given at least 24 hours to recuperate from minor damage, like a Beastie Boys concert, says Sig Soli, Ph.D., head of the department of communication sciences and devices at the Better Ear Institute in Los Angeles. And if you've already logged hundreds of hours with the volume at 11, there's a pill that might put your hearing levels back in check.
That pill is based on an amino acid called n-acetylcysteine that naval researchers are studying. N-acetylcysteine helps stimulate the production of a protein, glutathione, that acts like a park ranger for the hairlike cells. Glutathione absorbs a toxin that attacks the sound receptors as a result of noise overload. Sold as a supplement, the Hearing Pill is currently available ($35, American BioHealth Group) but not FDA approved (supplements aren't subject to FDA regulation). Additional testing is under way to pinpoint just how effective these pills are.
The coolest research of all involves reversing hearing loss by growing new sensory cells. Researchers at the Kresge Hearing Research Institute in Ann Arbor, Michigan, stimulated new cell growth with gene therapy in deaf guinea pigs. Within our lifetime, experts say, we might be able to grow new ear cells just as fast as we lose them — a huge bummer to hearing-aid makers everywhere.
Your Breasts
Anyone who's spent time in a ladies' locker room has seen the disheartening effects time can have on the girls. What's even more disturbing is that our chances of getting breast cancer go up as we age. One culprit is the burst of estrogen and progestin released monthly during ovulation to stimulate the cells lining the milk ducts to multiply. Over time, cells can make mistakes. "The more times cells divide and reproduce their genetic information, the more likely it is you'll start to see some genetic accidents," says Christy Russell, M.D., chair of the American Cancer Society's breast cancer advisory group.
A good sports bra supports your breasts in more ways than one — assuming you're actually exercising in it. Scientists have proven over and over that even moderate activity — roughly 2 hours of exercise a week — can reduce a woman's risk of breast cancer by 20 percent. One reason may be that your ovaries produce slightly lower levels of hormones when you're regularly working out, Dr. Russell explains, reducing the amount of estrogen and progestin sent to your breasts.Aside from following all the obvious health rules (don't smoke, keep your weight in check, don't overindulge in alcohol, etc.), your best measure is to stay vigilant with your gyno checkups. Should something troubling appear, early detection can make all the difference. According to the National Breast Cancer Foundation, there is a 96 percent survival rate when breast cancer is found early.
That's why some rapidly developing advances in mammography are so important. Digital mammograms (as opposed to standard x-ray film versions) and MRIs for breast screening have made leaps in recent years, offering clearer images and more accurate readings. They will be more widely available — and more affordable — as they improve. Another screening method showing promise is called MR spectroscopy. Through an MRI machine, a technician uses a computer program that bounces radio waves off suspicious cells to decipher their chemical composition, says Lia Bartella, M.D., assistant professor in the department of breast imaging at Memorial Sloan-Kettering Hospital in New York City. These images can show whether a tumor is benign or malignant without requiring a biopsy. "This can prevent 58 percent of women from undergoing unnecessary biopsies," Dr. Bartella says. She expects thetechnology to take hold inthe next 5 years.
Further down the road, mammograms and breast scans may become things of the past. Scientists are developing a diagnostic blood test much like the one now used to detect prostate cancer. The test would find the proteins made by cancer cells long before a tumor is large enough to be discovered any other way. "Ten years from now, a woman might be able to have a breast cancer profile done along with her cholesterol test," says Christine Laronga, M.D., associate professor of surgery at the Moffitt Cancer Center at the University of South Florida in Tampa.
And if the docs do find a tumor, in the next 10 years they'll have much smarter tools to help them get rid of it. The American Society of Breast Surgeons recently endorsed a procedure called accelerated partial breast irradiation (APBI). Instead of bombarding a patient with radiation all over the breast, doctors can now deliver it to just the trouble spot. Because less of the body is affected, higher doses can be given, so treatment takes only 5 days instead of 6 weeks. Another development to watch: radiofrequency ablation. Commonly used on liver tumors, it destroys the tumor with electric current and ultrasound rather than hugely invasive surgery. Two major cancer centers are currently studying its potential use on breast cancer.
Your Heart
It's easy to write off heart trouble as something that plagues only cheeseburger-inhaling ex-presidents. But cardiovascular disease is a huge concern for women — it's our number one killer. As we age, blood vessels lose flexibility, and cholesterol causes layers of plaque to pile up. This means the heart has to work harder to pump blood, so your blood pressure climbs. "Women who haven't been to the doctor in years often think they've suddenly developed high blood pressure," says Nieca Goldberg, M.D., chief of women's cardiac care at Lenox Hill Hospital in New York City and the author of The Women's Healthy Heart Program. "But really, it's been happening for years."
One solution likely to surface in the next 10 years is much higher definition CT scans, says Andy Kessler, a technology analyst and the author of The End of Medicine. "These scans will be able to find arteriosclerosis [the hardening and blockage of arteries] in women earlier, so fewer will die of heart attacks and strokes," Kessler says.If you've got high cholesterol (anything above 240), a precursor of heart disease, doctors currently prescribe statins such as Crestor, Lipitor, or Zocor. These drugs inhibit the liver's ability to produce LDL cholesterol (the bad kind). More effective drugs, called CETP (cholesterol ester transfer protein) inhibitors, will be available in the next couple of years. CETP inhibitors prevent the production of a protein that turns HDL cholesterol (the kind that actually removes existing cholesterol from artery walls) into LDL cholesterol, its evil twin. One CETP inhibitor, torcetrapib, may get FDA approval as early as next year, and more are in the works. Meanwhile, Avant Pharmaceuticals has a vaccine in development with the same HDL-boosting effect as the CETP inhibitors.
But drugs don't have to be the answer. "You can reduce your risk of heart disease by 82 percent with simple lifestyle changes," says Jennifer Mieres, M.D., director of nuclear cardiology at New York University Medical Center. Exercise (30 minutes of aerobic activity four times a week) improves the flexibility of your blood vessels. And a low-fat diet reduces the amount of fat that lines them.
Your Skeleton
By your 30th birthday you've reached peak bone mass, says Ethel Siris, M.D., director of the Tony Stabile Center for the Prevention and Treatment of Osteoporosis at NewYork-Presbyterian Hospital. At that point, you're still building bone, but your body is breaking down the existing bone faster than you can replace it. After age 35 or so, the average woman loses between 0.3 and 0.5 percent of her bone density per year. This loss, if left unchecked, will result in the porous, brittle bones that come with osteoporosis — and that trademark hunchback. Half of women over 50 will suffer an osteoporosis-related fracture at some point. Without preventive measures, you'll be at risk for acting out one of those I've-fallen-and-Ican't-get-up commercials.
But you can still protect your bones. Like muscles, bones get stronger when you use them — through weight training, aerobic exercise, even walking. "Bone responds to stress by getting harder," explains Kirby Hitt, M.D., an orthopedic surgeon and director of Adult Reconstructive Surgery at Scott & White Hospital in Temple, Texas. (See page 112 for workouts to keep your bones strong.)
While bionic limbs probably won't be on the market for grannies anytime soon, researchers are on the trail of some truly stranger-than-fiction methods for repairing and replacing bone. A team at the University of Michigan has discovered a gene that stimulates bone growth. And a group at Vanderbilt University in Nashville is planning human trials on a technique in which they transplant new cells grown from a healthy portion of bone to a part of the body where they're needed. Other research involves repairing cartilage and bone with hyaluronan, a lubricating substance naturally found in the joints. But it will likely be at least 10 years before any of these treatments become widely available.
Much closer to market is a bone-bolstering drug called denosumab. Injections of the substance seem to inhibit the protein that promotes bone deterioration, and several studies have shown its potential for alleviating the effects of osteoporosis, arthritis, and bone cancer. So drink your milk, do your reps, and know that with a little help from science, you'll be hiking, biking, swimming, and doing all the things you love to do — from now until at least 2076.
— With additional reporting by Jane Di Leo
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