This is the biggest health challenge women face in their 60s

A surprising number of women don’t realize it, but their biggest health risk in their 60s is heart disease. It’s the leading cause of death in women in the United States, so many key recommendations focus on maintaining cardiovascular health.

It’s also important to know and recognize the symptoms of a heart attack because they’re often different in women than in men. Though women may experience the typical chest pain associated with a heart attack, they’re more likely than men to experience a combination of symptoms, says Stacey Rosen, a cardiologist at Northwell Health in New York City.

“Women will often get shortness of breath, accompanying chest pain, back pain, a fatigue that’s easy to write off,” Rosen says. “You have that Spidey sense. If something’s not right, get it checked out because this becomes dangerous time for women.”

At age 65, women in the U.S. qualify for Medicare—the government-funded federal healthcare insurance program that replaces individuals’ private insurance—and everyone in this age group should take advantage of the initial “Welcome to Medicare” wellness exam covered in your first year of the program. It gives your provider and you an opportunity to get a thorough snapshot of your current health and biggest risks as well as review the preventive health services and screenings you should be getting.

In fact, Medicare covers a wellness exam every year. You can likely expect basic screenings for hearing loss and for cognitive health at these exams, says Jorge Ruiz, a geriatrician at Memorial Healthcare System in Hollywood, Florida, and your provider will review what else might be recommended for you.

But keep in mind, Ruiz adds, that “these are guidelines, and they shouldn’t be too rigid, especially as you get older.” Your provider should be helping you consider the risks and benefits of any screenings for your specific health situation as you start heading toward your golden years.

Cardiovascular, metabolic, and brain health

Nearly half of all adults have high blood pressure, according to the Centers for Disease Control and Prevention, but only one in four adults with high blood pressure have it under control. Unmanaged hypertension substantially increases your risk for heart disease and stroke, so working with your provider to keep it below 130/80 is important for your cardiovascular health.

Another reason to look after your heart is for that other organ people start worrying about as they age — the brain. Risk of dementia begins to increase above age 65, so “being proactive to reduce one’s risk of dementia is obviously very important,” Thomas Wisniewski, a neurologist at NYU Langone Health, says.

“What’s good for your heart is good for your brain,” especially because the brain is the most “oxygen-hungry” organ in the body, he says. “Having a healthy vascular system is very important for brain health and resilience, so just being physically active is very protective,” as well as keeping medical issues such as high cholesterol, high blood sugar and hypertension well managed.

Other ways to reduce risk of cognitive decline include eating a Mediterranean diet, getting adequate sleep, staying mentally active, and getting screened for sleep apnea if you snore—the risk increases with age. “Be diverse with mental stimulation,” Wisniewski says. “Reading, discussing what you read, being socially interactive, doing new things, taking up lessons, adult learning, crossword puzzles, Sudoku, jigsaw puzzles—all of those things in aggregate are highly beneficial.”