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Heart health after menopause: What every woman should know

If you’re a woman who’s gone through menopause, it’s time for a serious heart-to-heart with your doctor. A study presented at the American College of Cardiology’s Annual Scientific Session highlights a concerning acceleration of a woman’s heart disease risk after menopause.

This means women quickly catch up to men of a similar age and health status in terms of heart trouble. So, are we doing enough to screen and protect women’s heart health during this vulnerable stage?

Menopause and hearth health

“This is a unique study cohort of only post-menopausal statin users that signals that post-menopausal women may have a risk of heart disease that is on par with males,” said Dr. Ella Ishaaya, lead author of the study and an internal medicine physician at Harbor-UCLA Medical Center.

The study delved into how plaque buildup (measured by coronary artery calcium (CAC) score) changes in male and female. Plaque is a buildup of fatty substances, cholesterol, and other materials that hardens and narrows the arteries within the heart.

CAC scores provide a strong indicator of the presence and extent of hardened plaque within the heart’s arteries. A higher CAC score directly correlates with a higher risk of heart attack.

Here’s the worrying part: postmenopausal women, even those on cholesterol-lowering statins, experienced a much faster build-up of plaque compared to men in the study.

This accelerated plaque accumulation translates to a swift and surprising surge in cardiovascular risks that were previously underestimated in postmenopausal women.

What changes heart health post menopause

Before menopause, women benefit from the presence of estrogen, a hormone that offers a degree of cardiovascular protection.

However, during the menopausal transition, estrogen levels decline significantly, removing this protective effect. This hormonal shift has several consequences for heart health:

Accumulation of abdomen fat

The drop in estrogen influences fat distribution, often leading to increased fat accumulation around the abdomen. This type of fat (visceral fat) is strongly associated with an increased risk of heart disease.

How your body handles fat

Changes in estrogen levels affect the way the body metabolizes fats and cholesterol. This can lead to an increase in harmful cholesterol levels (like LDL), a major contributor to cardiovascular problems.

Clotting factors change

Estrogen impacts blood clotting mechanisms. As estrogen levels decline, changes in the way blood clots can increase the risk of both heart attacks and strokes.

“Women are underscreened and undertreated, especially post-menopausal women, who have a barrage of new risk factors that many are not aware of. This study raises awareness of what those risk factors are and opens the door to indicating the importance of increased screening for coronary artery calcium (CAC),” said Dr. Ishaaya.

Statins for heart health after menopause

You might rely on statins to keep your cholesterol in check. Statins are a class of prescription medications commonly used to lower cholesterol levels, particularly “bad” cholesterol (LDL).

However, this study suggests they may not be the complete answer for post-menopausal women. Further research is needed to see which medications and strategies are most effective in shielding women’s hearts during this vulnerable time.

Heart health: A problem for everybody

This research is a wake-up call to women and to the healthcare community. The research reminds us that:

This isn’t just a guy problem

Heart disease is often wrongly perceived as predominantly a male health concern. However, it is crucial to understand that heart disease is the leading cause of death for all the genders.

Do not fall for the misconception that it primarily affects men – your risk is significant and requires attention.

Menopause alters hormones, affecting heart health

The hormonal shift experienced during menopause has substantial implications for your cardiovascular health. The decline in estrogen eliminates a layer of natural protection your heart previously enjoyed. It’s essential to grasp the link between these changing hormone levels and the increased vulnerability of your heart.

Doctor’s consultation

Maintaining an open and ongoing dialogue with your doctor about heart health risks is vital, especially as you transition through menopause.

This includes regular consultations regarding potential heart health screenings or preventative measures that may be appropriate for your specific circumstances. Don’t hesitate to proactively ask about a CAC heart scan to assess plaque buildup.

Knowledge is power

Typical heart attack symptoms portrayed in the media often center around dramatic chest pain, which might be less common in women.

Educate yourself about the specific ways women experience heart attacks, including less obvious symptoms like shortness of breath, nausea, back or jaw pain, and unusual fatigue. Recognizing these subtler signs can be lifesaving.

Heart health risk factors beyond menopause

While the decline in estrogen during menopause marks a significant increase in heart disease risk for women, it’s crucial to remember that heart health is a lifelong concern.

Staying vigilant with proactive measures at any age is essential for minimizing your risk of heart problems down the road.

Key risk factors to watch out for:

  • Family history of heart disease: If heart disease or early heart attacks run in your family, your own risk is elevated. Share this information with your doctor so they can tailor your care accordingly.
  • High blood pressure: Uncontrolled high blood pressure puts significant strain on your heart and blood vessels. Regular blood pressure checks are a must, and if levels are high, work with your doctor to manage it.
  • Diabetes: Having diabetes significantly increases your risk of heart disease. Blood sugar control is key, along with regular heart health monitoring.
  • Conditions like Autoimmune diseases: Conditions like rheumatoid arthritis or lupus can increase inflammation throughout the body, raising your risk for heart disease.

Boosting heart health post-menopause

A commitment to healthy lifestyle choices is non-negotiable for promoting heart health, both independently and in conjunction with prescribed medications. Here’s how to create a strong foundation for your heart’s well-being:

A heart-healthy diet

Fuel your body with goodness. A diet rich in the following provides essential nutrients and helps manage heart disease risk factors:

  • Fruits and vegetables: Aim for a wide variety of colors to maximize your intake of vitamins, minerals, and antioxidants.
  • Whole grains: Choose these fiber-rich options over refined grains for better blood sugar control and cholesterol management.
  • Lean protein: Fish, poultry, legumes, and nuts are healthy choices. Limit red and processed meats.
  • Healthy Fats: Opt for sources like olive oil, avocados, and nuts instead of saturated and trans fats.

Regular exercise

Make movement a priority. Aim for at least 150 minutes of moderate-intensity aerobic activity (like brisk walking) or 75 minutes of vigorous-intensity activity (like running) per week. Also, include strength training at least twice a week.

Weight management

Maintaining a healthy weight reduces strain on your heart. If you need to lose weight, focus on gradual, sustainable changes in your diet and exercise habits.

Not smoking

Smoking severely damages blood vessels and accelerates heart disease. If you smoke, quitting is one of the best things you can do for your heart (and your overall health).

Stress management

Chronic stress negatively impacts heart health. Find healthy outlets for stress, such as exercise, mindfulness practices, or spending time in nature. If stress feels overwhelming, consider working with a mental health professional.

Prioritizing heart health after menopause

This research should be a rallying cry for women and the medical community. We must advocate for better understanding, improved screenings, and personalized heart health care for women, especially as they navigate menopause.

Let’s champion healthy hearts beyond superhero estrogen, and work to reduce a major cause of women’s suffering and mortality. Don’t you agree?


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