Heart disease is the biggest killer in Orkney and more women than ever before are at risk.

Although cancer tops the media headlines for killer diseases it is a fact that one in two women will die of heart disease or stroke compared with one in 27 women who will die of breast cancer. In 2001 there were 57 deaths in Orkney attributable to heart disease, compared to 45 for all cancers.

Heart disease and preventing it is a priority for NHS Orkney's new Coronary Heart Disease Managed Clinical Network. It has been set up to review and redesign coronary heart disease services in Orkney and to raise people's awareness of the risks and how these can be reduced by adapting individual's lifestyles.

Women are increasingly at risk of heart disease for a variety of reasons, including smoking and that in general women live longer than men.

Female hormones protect women from cardiovascular disease until the menopause, so that while it's true that fewer women than men get heart disease before the age of 50, between the ages of 60 and 70 the gap narrows.

Cardiovascular disease includes diseases of the heart and blood vessels which can develop over time and occurs when arteries become narrowed by cells, fat and cholesterol. If a blood clot or other particle suddenly breaks off and blocks blood flow in an artery this can lead to a heart attack or stroke.

So what can we do to avoid heart disease?

"A great deal," says NHS Orkney's cardiac specialist nurse Joy Groundwater, " and much of it relies on common sense - a healthy diet with at least five portions of fresh fruit and vegetables a day and regular exercise."

The latest statistics show that 55.5 per cent of women and 66.4 per cent of men are classed as obese while only 30 per cent of women and 41 per cent of men take regular exercise. We eat too much and exercise too little.

"Being overweight and exercising regularly can be healthier than being slim and idle," said Joy. "We sometimes rely too heavily on diets to make us fit and believe we can't do the exercise until we lose the fat. Many big people who are put off undertaking exercise because of their size will only see their problem getting worse as they wait."

"It's a fallacy that you have to be slim and toned to get into a track suit or leotard. Losing weight may well be a benefit of doing regular exercise but the real benefit is increasing overall fitness and with it feeling more energetic and healthy."

And the exercise doesn't have to be in the gym. 30 to 45 minutes of moderate to vigorous physical activity five days a week is recommended. Included in the moderate category is vacuum cleaning, walking the children to school and back, DIY, mowing the lawn, and cycling to work. Hard cycling, dancing and swimming are included in the vigorous category. All these things can be done by people who are overweight.

Joy advised: "Your heart will work more effectively with regular exercise and it will help lower blood pressure, boost the level of protective HDL cholesterol, increase oxygen supply to muscles, and reduce fat while increasing muscle."

Women are also urged to give up smoking. Women who smoke have four times the risk of having a heart attack as women who don't, but five years after stopping the risk is the same as for non smokers. It's never too late to stop.

Joy is also concerned that some women already suffering from the warning signs of heart disease are ignoring them and said: "Women often blame chest pain on indigestion or the general aches and pains of unfitness. The pain could be angina and it's important to consult your GP without delay."

Warning symptoms - a guide

• Chest tightness, squeezing or burning feeling OR dull ache, heaviness in chest
• Hard to breathe, feel restricted
• Pain may spread to arms, jaw, neck, back or stomach
• Pain may only affect arms, jaw, neck, back or stomach
• Pain is usually brought on by effort such as climbing stairs, walking uphill, carrying shopping or any exercise
• Pain worse in cold weather or when angry
• Pain does not usually last long if exercise stops or you relax. Discomfort should go after 10 minutes
• Women may have pains that cannot be pinned down. Do not ignore them. They may be harmless but see your GP.