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How To Prevent Heart Disease After Menopause

Top 10 Prevention Tips For Heart Disease In Later Life

HOW TO PREVENT HEART DISEASE IN POSTMENOPAUSAL WOMEN | 6 MUST KNOW TIPS

The menopausal phase in a womans life is an important window where preventative measures can be most effective with the right intervention:

  • Stop smoking and avoid second-hand smoke.
  • Reduce alcohol consumption and follow the recommended daily limits. Consumption of 1 2 standard alcoholic drinks per day may reduce the risk by 30%. , However, excessive alcohol intake increases the risk of heart disease.
  • Regular aerobic exercise up to 30 minutes per day at least five times per week.
  • Healthy diet reduction in sugar consumption a low-fat, high-fibre diet including whole grains and fruit and vegetables. , Five portions a day reduces risk by about 25%.
  • Control of body weight if overweight or obese.
  • Consider Menopausal Hormone Therapy in pre-menopausal women younger than 60, not only to help manage hot flushes and other symptoms of the menopause transition but also potentially, to help prevent heart disease.
  • Lower blood pressure if elevated.
  • Seek expert medical advice.
  • If you would like to discuss any areas in this information booklet, please arrange a visit to your healthcare professional. It is important that your options and prevention strategies are fully explored.

    Menopause And Heart Disease Prevention And Treatment Options

    Menopause and heart disease treatment may include various medications or surgical procedures to increase blood flow in the heart

    Women who have diabetes and who smoke are at higher risk for heart disease than the general population. Similarly, those with high cholesterol levels, high blood pressure or who are obese are also at higher risk. Individuals who have a sedentary lifestyle, or with a family history of heart disease, should take steps to lower their risk. If you have any of these conditions, you should be under the care of a physician who can help to lower your risk.

    Hormone replacement therapy to replace estrogen in the body is not always the best option for preventing heart disease in women. Talk to your doctor about menopause and heart disease prevention to determine the right approach for your individual health needs. Take steps in your daily life to protect your heart health.

    Eat a healthy diet, low in fat and high in antioxidants from fresh fruit and vegetables. If you smoke, talk to your doctor about ways to stop. Exercise regularly, whether taking simple walks or more strenuous activities. Maintain a healthy weight. Menopause and heart disease treatment may include various medications or surgical procedures to increase blood flow in the heart.

    Mht After Breast Cancer

    Management of menopause symptoms should be individually tailored and carried out in close liaison with the oncologist. Lifestyle alterations and non-hormonal treatment options, such as clonidine, SSRIs, venlafaxine, gabapentin, and pregabalin are recommended first line in these women., Although these are effective for mild-to-moderate vasomotor symptoms, their use is often limited by side effects. SSRIs such as fluoxetine and paroxetine should be avoided in women on tamoxifen due to inhibition of the CYP2D6 enzyme pathway which may reduce its efficacy. Complementary therapies such as isoflavones, soy, red clover, and black cohosh are not recommended as they may have oestrogenic effects and there is a lack of data regarding safety and efficacy, although some may have SERM-type effects .

    Data regarding the safety of MHT in breast cancer survivors are limited, as several studies were terminated early due to an increased risk of recurrence in the interim analysis., Current UK guidance suggests to reserve MHT for those with refractory symptoms after other non-hormonal treatments have been unsuccessful . Other guidelines advise against MHT in oestrogen receptor-positive breast cancer.,

    Practice points .
    • BRCA1/2 gene mutation carriers and women treated for breast cancer have increased risk of CVD. Check for their cardiovascular risk factors.

    • Short-term HRT in women after RRSO does not increase breast cancer risk and reduces the long-term effects of early/premature menopause.

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    Pregnancy In Women At Increased Risk For Ihd

    Due to an increasing maternal age of pregnancy, a greater number of women are at risk for stable or unstable IHD during pregnancy., In a large US cohort of 1.6 million pregnancies, HPD were associated with 1.4- to 7.6-fold higher risk of MI, heart failure, and stroke. Mortality data have been reported as high as 510% in elderly cohorts., In the European registry of pregnancy and cardiac disease , women with IHD accounted for about 4% of 5739 included pregnancies. Although these women were typically older and more often multiparous, no mortality was observed and in only 4%, heart failure was reported. Recent findings in a UK cohort of 79 women with pre-existing IHD reported only 6.6% adverse cardiac events without any maternal deaths. However, the rates of adverse obstetric and neonatal events were increased, with an occurrence rate of pre-eclampsia in 14%, preterm delivery in 25%, and small-for-gestational age in 25%. Foetal risk may therefore be higher than maternal risk in women with known IHD. In women with a prior SCAD, a new pregnancy seems to be well tolerated without evidence of an increased risk of SCAD recurrence.

    Practice points .

    Can Hormone Replacement Therapy Impact My Risk Of Heart Disease

    Menopause and Heart Disease: What Are Risk Factors?

    Hormone replacement therapy and heart-related dangers have been the subject of many studies. There are indications of some possible benefits, depending on your age.

    Women who became menopausal less than 10 years before starting HRT have no increased risk of a heart attack. The same holds true for those who were between the ages of 50 and 59 while taking it.

    Younger women also show no risk and may even find their risks lowered. Still, women over the age of 60 or who became menopausal more than 10 years ago, could have a slightly increased risk of a heart attack.

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    How Can Menopausal Women Reduce Their Risk Of Heart Disease

    A healthy lifestyle goes a long way in preventing heart disease in women. Incorporating the following tips into your everyday life may help you reduce your risk of heart disease during and after menopause:

    • Avoid or quit smoking. Smokers have twice the risk of heart attack than nonsmokers. In addition to eliminating cigarettes, stay away from secondhand smoke, as it also increases the risk of heart disease.
    • Maintain a healthy body weight. The more you are over your ideal weight, the harder your heart has to work to give your body nutrients. Research has shown that being overweight contributes to the onset of heart disease.
    • Exercise throughout the week. The heart is like any other muscle — it needs to be worked to keep it strong and healthy. Being active or exercising regularly helps improve how well the heart pumps blood through your body. Activity and exercise also help reduce many other risk factors. It helps lower high blood pressure and cholesterol, reduces stress, helps keep weight off, and improves blood sugar levels. Check with your doctor if you have been inactive before increasing your activity level.
    • Eat well. Follow a diet low in saturated fat low in trans fat and high in fiber, whole grains, legumes , fruits, vegetables, fish, folate-rich foods, and soy.
    • Treat and control medical conditions.Diabetes, high cholesterol, and high blood pressure make you more likely to have heart disease..

    Signs And Symptoms Of Heart Disease During Menopause

    Women should also be aware that heart attacks often have different symptoms in women than in men. Women are more likely to experience abdominal, shoulder or back pain, during a heart event. Throat or jaw pain can also occur. You may experience a feeling of severe fatigue.

    Nausea and vomiting may be a sign of a heart event. You may feel light-headed or dizzy, or may sweat profusely. You may feel short of breath or have pain in one or both arms. These are possible symptoms of a heart problem that should receive immediate medical attention.

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    Healthy Lifestyle In Menopause

    The loss of oestrogen has been associated with reduced energy expenditure. Lower oestrogen levels are associated with feeding behaviours and meal size, promoting hyperphagia and obesity.,, Obesity is also associated with depression, which enhances food intake and sleep deprivation and reduces physical activity. Effective management of vasomotor symptoms with menopausal hormone therapy may reverse this. Regular physical exercise has a beneficial effect on vasomotor symptoms and quality of life. Although oestrogen therapy is not approved to treat perimenopausal depression, there is evidence that it has antidepressant effects and increases well-being in perimenopausal women.

    Improvement of quality of life enhances the ability to work. Women suffering from severe menopausal symptoms have an eight-fold increased risk of working disability, leading to lower productivity, more absenteeism, earlier termination of workforce participation, and a rise in employer and healthcare community costs.,

    Practice points .
    • Adherence to a healthy lifestyle and diet with regular exercise are important factors in the optimal management of menopausal health

    Heart Disease And Menopause

    Early Menopause: Precursor to Coronary Heart Disease?

    In the U.S., heart disease is the leading cause of death for women of all ages. However, the risk increases significantly for women who have gone through menopause. Heres all you need to know about heart disease and menopause. Well discuss how the two are related, possible symptoms and how to reduce the risk.

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    How Do I Stay Healthy After Menopause

    It is important to maintain a healthy lifestyle, especially as you age and your risk for certain medical conditions increases. Some ways for people in postmenopause to stay healthy include:

    • Exercising regularly. Walking, doing yoga or strength training can help lower your risk for many medical conditions.
    • Weight-bearing exercises can strengthen your bones and muscles.
    • Eating a healthy diet. Foods like fruits, vegetables, lean meats and whole grains should make up the bulk of your diet. Avoid lots of salt or sugar and limit your consumption of alcohol.

    Going through menopause can be uncomfortable and present new challenges and health concerns. Speak with your healthcare provider about any symptoms you feel or questions you have. They can help make sure you are supported through this time and get the care you need.

    Read more on:postmenopause

    Womens Heart Health Is Not Just About Hormones

    The common view is that cardiovascular disease mainly affects men, but it is also the leading cause of death in women worldwide. And, as with men, morbidity and mortality in women increase drastically with age.

    Despite its burden, cardiovascular disease is considered to be largely preventable. Reports from the World Health Organization, as well as heart-health agencies around the globe, conclude that the onset of cardiovascular disease can be avoided by controlling several risk factors, including cholesterol levels, blood pressure and tobacco use.

    But the big question regarding women and heart disease pertains to the steep rise in incidence at menopause. And this is where conventional wisdom needs to be updated.

    In 2020, the American College of Cardiology issued . This set of recommendations acknowledged sex-specific risk markers for cardiovascular disease. It highlighted pregnancy-related conditions as well as premature menopause, polycystic ovary syndrome and psychological stress.

    The situation gets murkier when deciding whether this hormonal link also applies to postmenopausal women. Should disease in these women be diagnosed and treated with consideration of low female-hormone levels an approach that could lead to recommending menopausal hormone therapy . Or should postmenopausal women be evaluated using similar criteria to those for men, in which hormone levels are not generally considered?

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    Menopause And Heart Disease

    Heart disease risk rises for everyone as they age, but for women symptoms can become more evident after the onset of menopause.

    Menopause does not cause cardiovascular diseases. However, certain risk factors increase around the time of menopause and a high-fat diet, smoking or other unhealthy habits begun earlier in life can also take a toll, said Dr. Nieca Goldberg, a cardiologist and an American Heart Association volunteer.

    Menopause isnt a disease. Its a natural phase of a womans life cycle, Dr. Goldberg said. Its important for women, as they approach menopause, to really take stock of their health.

    On average, the onset of menopause, when menstrual periods permanently stop, occurs around age 54, said Dr. Goldberg, medical director of the Joan H. Tisch Center for Womens Health at New York University Langone Medical Center.

    More than one in three female adults has some form of cardiovascular disease. An overall increase in heart attacks among women is seen about 10 years after menopause. Heart disease is the leading killer of women.

    Does Hrt Help Your Heart

    How to Avoid Heart Problems After Menopause

    So is estrogen replacement the answer to heart concerns after menopause? Not really, said Dr. Banthia.

    While hormone replacement therapy can help some women manage their menopausal symptoms for a few years, theres really no evidence that it helps lower your risk of cardiovascular disease, she said. Plus, hormone replacement therapy does have its risks, such as blood clots and stroke.

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    Menopause Involves The Whole Body And May Call For More Than A Gynecologists Care

    The hormonal changes that occur during menopause can bring increased cardiovascular risk in the form of higher blood pressure and cholesterol levels.

    If cardiovascular disease runs strongly in the family, its also important that you see a cardiologist to further assess the likelihood of having cardiovascular disease and to optimize treatment.

    Johns Hopkins Women’s Cardiovascular Health Center

    The Johns Hopkins Womens Cardiovascular Health Center provides education, comprehensive treatment and diagnostic services to prevent and manage heart disease in women.

    Use Of Menopausal Hormone Therapy Since Womens Health Initiative

    A more recent meta-analysis of RCTs and data from a Finnish register confirm that initiating MHT within 10years of the onset of menopause significantly reduces MI and death around 50%, whereas discontinuation of MHT resulted in a transient increase in coronary death. Thus, many studies following the initial WHI reports largely support a preventive effect of MHT on CVD. Recent MHT studies such as the Kronos Early Estrogen Prevention Study and the Early vs. Late Intervention Trial with Estradiol have focused on recruiting mainly younger women using more favourable MHT regimens with surrogate cardiovascular endpoints., The ELITE trial demonstrated less progression in carotid intima media thickness in younger women randomized to MHT compared to older women who were more than 10years post-menopause . Possible mechanisms mediating the CVD benefit of MHT, especially transdermal, include increase in insulin sensitivity, improvement of the lipid profile and body composition, decrease in BP in case of drospirenone-containing regimens, and finally, a direct vasodilatory and anti-inflammatory effect.,,

    Modern MHT regimens contain lower doses of systemic and vaginal oestrogens. Oral, but not transdermal, MHT increases the risk of venous thromboembolism . Current evidence is summarized in Table .

    Benefits .

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    Other Risk Factors Of Menopause Heart Disease

    While aging itself is linked to an increased risk of cardiovascular disease for both men and women, those risks are even higher for menopausal women due to a number of physiological changes that occur in that life stage:3,4,5,6

    • Menopausal weight gain. Excess weight is a risk factor for cardiovascular disease for all age groups. Menopausal women are more prone to weight gain, particularly around the waist, further increasing the risk of heart issues.

    • Hypertension. High blood pressure – another risk factor of cardiovascular disease – is more common in middle-aged women than in men of the same age.

    • Abnormal lipid levels. The levels of low-density lipoprotein and triglycerides tend to increase in menopause, while high-density lipoprotein decreases, exposing women to a higher risk of heart problems and blood clots.

    • Unhealthy habits. Smoking, a diet rich in saturated and trans fats, and a sedentary lifestyle are directly linked to cardiovascular disease. Many of such risks are higher in women than they are in men.

    • Diabetes. Following menopause, women may experience changes in their blood sugar levels, which – if left uncontrolled – can increase their risk of cardiovascular disease and other complications.

    • Family history. Having close relatives who suffer from heart disease may further increase women’s risk of developing such problems on their own after menopause.

    Other Chronic Gynaecological Conditions Associated With Cardiovascular Disease Risk

    Heart Disease and Menopausal Women

    There is considerable overlap between gynaecologic conditions and chronic disease, particularly CVD. In addition to the gynae-endocrine disorders , endometriosis, uterine fibroids, and hysterectomy < 50years with ovarian conservation have all been associated with increased CVD risk. Endometriosis is associated with enhanced inflammation, oxidative stress, and an adverse lipid profile. Although causal relationships have not been proven, the gynaecological and reproductive history may provide important insights into potential long-term health risks in women for which a more systems-wide approach may be beneficial.

    Practice points .

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    Vasomotor Symptoms And Cardiovascular Disease Risk

    Women with severe menopausal symptoms have an unfavourable cardiometabolic profile and overactivity of the sympathetic nervous system compared to asymptomatic women. Autonomic dysfunction enhances heart rate variability, which may result in symptoms of dyspnoea on exercise. Increased sympathetic activity with disabling vasomotor symptoms is more often present in women after HPD., In the Womens Health Initiative observational study, women with severe symptoms of hot flushes and night sweats had a 48% higher risk of incident diabetes at follow-up. They also have evidence of impaired endothelial function and increased subclinical atherosclerosis compared to women without vasomotor symptoms.

    Practice points .

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