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Changing Lifestyles, Changing Habits: Heart Risk after Menopause


If you’re a woman between the ages of 45 and 54, take note: your risk of heart disease increases when you get past menopause. When exactly is menopause? If you haven’t had a menstrual period for one year (not caused by illness, pregnancy, breast-feeding or medication), you are considered to be in menopause.

Why the Menopause/Heart Disease Link?
Your ovaries produce the two female hormones, estrogen and progesterone. You need these hormones to regulate your menstrual cycle and to ensure that you have a successful pregnancy.

As you get older, but before you reach menopause, you enter a phase called “perimenopause.” Your ovaries begin to shrink, and your hormone levels begin to fluctuate. Menstrual periods become irregular. Sometimes the bleeding is quite heavy. This phase lasts for several years. Eventually, your menstrual cycle stops. You’ve reached menopause.

Your estrogen level drops as you reach menopause. Estrogen tends to protect women from developing heart disease. It seems to increase HDL (good) and decrease LDL (bad) levels of cholesterol. This is why it’s more common for women to have their first heart attack at an older age than men usually do. They have that estrogen protection until menopause, and then that protection fades away.

Intensive risk management essential
For a while, researchers believed that replacing the decreasing estrogen would provide protective benefits against heart disease. Instead, results from two studies last summer showed that taking hormone replacement therapy can increase the risk of heart attack and blood clots. It increases the risk of cancer as well. Now, the American Heart Association does not recommend HRT either for women who have never had heart disease or for women who have.

The best bet for women is to manage their heart disease risk factors aggressively. These are the risk factors:

  • Family history of the disease (having a mother or sister who died of heart disease before age 65, or a father or brother who died of heart disease before age 55)
  • Smoking
  • Cholesterol higher than 240; blood pressure higher than 140/90
  • Sedentary lifestyle 
  • Being 55 and past menopause
  • Diabetes
  • Being African-American

The latest research indicates that perimenopause, the time before menopause begins, is an important time to think seriously about preventing heart disease. That’s when it’s time to make lifestyle changes that can decrease your risk factors. Women in their 40s—and women older than that—need to take a long look at what they can do now to give themselves the best chance for heart health in their near future. Here are some things steps you can take:

Go to the doctor regularly. You need to know your numbers. Find out what your blood pressure is. Find out what your cholesterol and triglyceride levels are. Find out if you’re at a healthy weight. You can’t address your own risk factors if you don’t know what they are. And when you do know what they are, talk seriously with your doctor about a plan of action.

Incorporate exercise into your day. There are many reasons why exercise helps your heart, and you’ve probably heard most of them. If you want to lower your cholesterol and triglycerides, lower your blood pressure, lower your weight and maybe even lower the inflammation that is thought to contribute to heart disease, exercise is essential. 

Learn to manage stress. Taking care of your mental state is important. Make sure you find time to relax. Do things you love, spend time with people you care about. If religion and spirituality are important to you, take time to cultivate a regular practice.

Change your diet, if necessary. How big are your portions? Are you getting plenty of fruits and vegetables? How much fast food do you eat? As we age, we tend to get extra fat around the abdomen, and that alone is a risk factor. Eat the right foods, in the right amounts, to lower your risk.

Heart attack symptoms can be different for women
Do you know the symptoms of a heart attack? The most common ones are

  • Chest pain
  • Chest pressure
  • Trouble breathing

Often, although certainly not always, women experience other symptoms, including

  •  Jaw pain
  • Cold sweats
  • Indigestion
  • Nausea

If you experience any of these symptoms, call 9-1-1. When you’re having a heart attack, every minute matters. The sooner you begin receiving emergency treatment, the higher your chances of survival, and the less damage your heart will incur. In many cases, people having a heart attack can get clot-dissolving drugs in the ambulance on the way to the hospital. This early step can keep heart muscle from dying.

Don’t delay preventive measures
Each year, 74,000 women under 65 die of heart disease. African-American women are 69 percent more likely to die of a heart attack than Caucasian women. Do your best to avoid becoming one of these statistics. Changes can be hard to make, but if you learn what you need to do and why, and then make your changes gradually, you’ll probably find that doing a few things differently now is a lot easier than having a heart attack later.

The American Heart Association; 7 March 2003 Report from American Heart Association’s 43rd Annual Conference; The National Heart, Lung, and Blood Institute
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