Heart disease risk rises for everyone as they age, but, for women, symptoms can become more evident after the onset of menopause. While menopause is a natural part of aging for women, it’s important for women to consider how changes at this time in life might affect their cardiovascular and overall health.
While menopause itself is not a risk factor for cardiovascular heart disease, many complex hormonal changes take place during menopause and some of them have been linked to an increase in cardiovascular disease. For one, a decline in estrogen may be the biggest factor in increased risk for cardiovascular disease for menopausal women. Estrogen is believed to have a positive effect on arteries and keeping blood vessels pliable.
Early natural menopause (that which occurs before or around 44 years of age) has also been associated with an increase in the risk of cardiovascular disease in two large studies. Despite the link between declining estrogen levels and an increase in cardiovascular disease in women, a causal relationship has not been established.
Many women may remember their mothers taking hormones to help relieve symptoms of menopause and reduce health risks. This was a popular therapy especially during the 1960s and 1970s. Based on research, there has been a shift in the use of hormone replacement therapy. Several large, well-known studies including the Women’s Health Initiative and the HERS trial, found that estrogen replacement had no cardio-protective effect and may have been harmful in some cases. Therefore, the American Heart Association has recommended against hormone replacement therapy as a way to prevent cardiovascular disease in peri- and post-menopausal women.
Other changes more prevalent at the onset of menopause include an increase in blood pressure, increase in bad cholesterol, or LDL, and no change or even a decrease in the “good” HDL cholesterol. Triglycerides, which are specific fats in the blood, tend to increase as well.
Other factors like smoking, obesity, family history, high blood pressure and diabetes are all large contributing factors in raising cardiovascular risks in women and should be prevented as much as possible. Most cardiologists agree that a healthy lifestyle goes a long way toward preventing the onset of heart disease in women, especially after menopause.
To promote optimal health following menopause, women should consider:
Stop smoking: Smokers have twice the risk than non-smokers of cardiovascular disease, and this includes second-hand smoke.
Watch your weight: Maintaining a healthy weight has many health benefits, not just helping to reduce the risk for cardiovascular disease. A healthy weight reduces the stress on blood vessels and your heart, which lowers risk factors.
Maintain healthy eating habits: Following a diet of fresh fruits and vegetables, good fats like olive oil, lean meats and fish and moderate portions of carbohydrates and dairy has shown to reduce many health risks including cardiovascular heart disease.
Get regular exercise: Like other muscles in your body, the heart needs exercise to keep strong. Regular exercise improves blood flow and improves how the heart pumps blood to the blood vessels. Exercise also helps reduce stress, which is good for overall health, especially cardiovascular health. Ideally, you should exercise 150 minutes a week or 60 minutes a day if you are trying to lose weight.
Treat with medications if necessary: Sometimes the addition of certain medications is necessary to control risk factors for cardiovascular disease. Always check with your primary care physician, gynecologist or cardiologist and have them monitor all medications that you may be prescribed.
While menopause does increase the risk factors in post-menopausal women, it is manageable with these simple lifestyle changes.
Good habits that you start earlier in life go a long way toward reducing your risk factors as you age.
Menopause is a natural part of the aging process but it does not need to be a large contributing factor in cardiovascular disease in women. Work with both your gynecologist and cardiologist to manage both symptoms and risks for maximum heart health.
Joanne K. Mazzarelli is a Clinical Cardiologist at Cooper Heart Institute.
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