Managing Menopause - Heart Disease

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Heart Disease

Women and heart disease

What is heart (cardiovascular) disease?

Cardiovascular disease affects either the heart or major blood vessels (arteries) supplying the heart, brain and other parts of the body. Today, it is the number one killer of both men and women in Australia.

From early in life, fatty cholesterol deposits called plaque gradually build up on the walls of arteries. Over time this causes a narrowing of the arteries, resulting in reduced blood flow to the heart and other vital organs. These cholesterol plaques can break apart at any time and cause blood clots to form in the blood vessels which block the artery. This blockage of blood supply can lead to chest pain (angina), heart attacks and stroke.

What is a heart attack?

When an artery to the heart becomes completely blocked, an area of heart muscle is starved of oxygen and consequently dies. Classically, symptoms include lasting, severe, central chest pain and sometimes pain spreading down the left arm or into the jaw. Anyone experiencing this should go to hospital immediately, or call an ambulance, as early treatment for heart attack can save your life.

Symptoms

The nature of symptoms including chest pain can vary. It can be experienced as a pressure, a shortness of breath or even feel like indigestion. Hence even mild chest pain, breathlessness or bouts of unexplained indigestion should be discussed with your health practitioner to ensure that these symptoms are not indicating underlying heart disease. Women in particular, and those with diabetes, can have mild or not typical symptoms. If a heart attack is occurring it is critical to get to a hospital urgently as emergency treatment can save vital heart tissue. Women often delay hospital attendance for too long and suffer unnecessary heart damage.

What is a stroke?

A stroke is the blockage or bursting of a blood vessel in the brain, causing damage to surrounding brain tissue. Symptoms of a stroke depend on which area of the brain has been affected, and can include severe headache, dizziness and confused speech. A stroke often occurs without warning, and weakness or paralysis down one side of the body, loss of speech, loss of swallowing reflex and sometimes unconsciousness may result. Hospital or ambulance treatment is urgently required.

What are the major risk factors for cardiovascular disease?

High blood pressure

Ideally blood pressure should be around 120/80 or below most of the time. Blood pressure does fluctuate, but consistent higher levels can damage artery walls and the heart itself, increasing the risk of heart disease, especially stroke. Have your blood pressure checked regularly and discuss your individual blood pressure target with your doctor. This is especially important if you have diabetes or high cholesterol.

Elevated blood cholesterol

Cholesterol is the small particles that the human body uses to carry fats around the bloodstream. Family history and genetic influences can affect cholesterol levels, so all people – even those with healthy diets and low body weight – need to have their levels checked regularly.

Smoking

Smoking significantly increases the risk of heart disease. Even a few cigarettes per day damages the blood vessels and increases cholesterol build up. Risk of stroke, blockage of leg arteries and heart disease are all increased. Risk decreases when you stop smoking.

Diabetes

Pre-diabetes and diabetes is a major risk factor for heart disease. Diabetes is common and half of those affected are unaware they have the condition. Discuss your risk of diabetes with your doctor and be tested if needed.

Factors that can influence cardiovascular disease

Family history (if the relative was under the age of 65 when the cardiovascular disease developed)
Cigarette smoking
Diabetes
Ethnic background
Excess body weight, especially when abdominal fat is increased
Lack of exercise
High blood pressure
Abnormal cholesterol

What can I do to reduce my risk?

Avoid smoking
Enjoy a wide variety of healthy foods
Limit animal (saturated) fats
Choose calcium-rich, low-fat dairy products
Eat fish high in omega-3 fatty acids twice a week
Reduce your salt intake
Maintain a healthy body weight
Exercise regularly – aim for 30 minutes of physical activity daily
Use relaxation techniques to reduce stress
Have your cholesterol, blood pressure and blood sugar levels checked regularly – know your numbers
Include phytoestrogen foods like soy products, legumes (chickpeas, lentils, red kidney beans, etc.), rice, grains, nuts and alfalfa regularly in your diet
Develop a health plan for prevention with your health professional

Understanding risk:

Most Australian women underestimate their risk of heart disease and stroke but one in every two Australian women dies of heart disease, 80% of which is preventable. This is an important issue to address. So be aware, have a check up with your health practitioner, know your numbers and help prevent heart disease.

Does hormone replacement therapy (HRT) have effects on cardiovascular disease?

Evidence suggests that combined HRT taken at the time of menopause does not increase the risk of heart disease. However, women taking combined HRT with oestrogen and progestin who start therapy later in life (average age in the Women’s Health Initiative study was 63 years) have a small increased risk of heart disease. Oestrogen alone does not increase the risk of heart disease. HRT, in tablet form, reduces cholesterol as well as having favourable effects on the blood-vessel wall. However, it also increases the risk of blood clots forming when blood-vessel plaques rupture. Currently HRT should be avoided in women with established heart disease.