Women catch up to men in heart disease risk |
Some women in their 40s dread hitting the mid-century milestone, especially facing the uncharted territory of menopause. Yet recent research suggests women are happiest between the ages of 50 and 70. Many enjoy having fewer work and family pressures than before, and more time, resources and self-awareness for pursuing new passions.
Growing older is not without challenges, of course, particularly if there are health problems. After menopause women catch up to men in risk of cardiovascular disease, hypertension, coronary artery disease and heart failure. The good news is that more is known about early identification and prevention of illness.
One of the most important things women at mid-life and beyond can do is pay attention to their hearts. Many women worry about breast cancer, but heart disease kills more women than all types of cancer combined.
Women’s higher risk of post-menopause heart disease is due in part to the loss of natural estrogen. For years it was thought that hormone replacement therapy (HRT) lessened the risk of heart disease. However, in 2002, The Women’s Health Initiative, a large clinical trial sponsored by the National Institutes of Health, challenged that theory. In fact, the initiative reported the popular estrogen-progestin therapy Prempro increased the risk of heart disease, blood clots and stroke, as well as breast cancer and dementia.
Women with bothersome menopausal symptoms, such as hot flashes, night sweats, bone loss and vaginal dryness, should work closely with their gynecologists to decide the best course of action. The physician may advise them that some symptoms can be addressed more effectively with targeted treatment, such as medications that specifically prevent osteoporosis or correct lipid disorders. And, estrogen applied topically delivers lesser amounts of hormone to the women’s system, so it’s a safer approach to vaginal discomfort than estrogen pills.
For a woman with serious hot flashes and difficulty sleeping, the gynecologist might prescribe HRT, but many would want to do so only at the lowest effective dose for the shortest time. The risk of stroke increases after as little as a year on HRT.
If HRT doesn’t reduce heart disease risk, what can help? Appropriate screening tests and a healthy lifestyle can go a long way to minimizing the risk. Regular exercise and a well-balanced, low fat diet including whole grains and lots of fruits and vegetables are recommended.
By age 40, a woman should have annual cholesterol and blood pressure screenings. If she smokes, is obese or has high blood pressure, high cholesterol, diabetes or a family history of heart disease she should have an Ultra Fast Heart Scan, which measures calcium build-up in the coronary arteries. The higher the calcium score, the higher the risk of coronary artery disease. Symptoms of fatigue, shortness of breath or leg swelling warrant a heart ultrasound (echocardiogram).
Cardiologist Maria Costanzo, MD, contributed to this article in cooperation with Edward Hospital. She is a member of the medical staff at Edward Hospital and Midwest Heart Specialists. For details, go to www.edward.org/hearthospital.