Menopause and Cardiovascular Disease

Friday, May 1, 2020

/ by Dr Vishal Zahra

Cardiovascular disease is one of the leading causes of death among women over the age of 50 in both under developed and developed countries. More women than men die each year due to heart disease. According to American Heart Association, 1 in 3 women have some form of cardiovascular disease. And until the age of 45, men have higher percentage of high blood pressure than women but from 45 to 64 years of age the percentage between men and women become similar and after the age of 64 women have higher percentage of high blood pressure than men.
Aging in Women
Not only the men and women’s psychology differs when it comes to aging but their bodies also physiologically respond differently to aging. Heart and blood vessels go through many changes as a part of aging. The stiffness in arteries increases with aging and due this our heart has to work much harder than normal in order to pump blood. With time the heart muscles also becomes weak leading to heart failure. All these changes are common in both men and women but along with all these effects of aging which are dangerous for our heart women have one more factor and that is estrogen depletion which makes all these changes in the heart more evident. As aging starts, different hormones act in a different way for men and women. For example as women reaches the age of fifty, menopause occurs and due to menopause estrogen depletion starts and these changes in the levels of estrogen for women are a major concern. But for men no such thing occurs at this very age.

Menopause is the point in women’s life when menstrual flow stops completely. It is between 45 to 55 years of age. The earlier the menopause, more are its associated risks.
 As menopause approaches the estrogen hormone starts to deplete. This estrogen depletion is thought to be the link between menopause and cardiovascular disease. Estrogen is mainly produced by the ovaries and also by adrenal glands and fat tissues. It has a protective role for the heart as it protects the inner layers of arteries and make them more flexible thus decreasing the risk of atherosclerosis or thickening of arterial walls.
Other factors
Along with estrogen depletion, many other changes also occur in a women’s body after menopause such as rising of blood pressure which in turn increases the load on the heart. Increased levels of low density lipid (LDL) or bad cholesterol while at the same time high density lipid (HDL) or good cholesterol levels remain the same or decreases. Triglycerides also increase. And building up of fatty deposits in arterial walls is major reason behind heart diseases. General aging and decreased ability of heart functioning is one thing but being a women and menopause which brings a complex hormonal changes with it is another danger for heart itself. There are still many other factors such as family history which increases the risk of cardiovascular disease in women, smoking cigarettes, obesity, stress, sedentary lifestyle etc
What we can do?
Actually, there is a lot we can do to prevent the cardiovascular incident in women who have gone through the normal process of menopause. If you follow a healthy lifestyle in younger age it will reward you in menopausal years. Even if you have reached that stage you can still make positive changes today that can prevent your condition from worsening.
HRT or Hormone Replacement Therapy:
HRT or Hormone Replacement therapy is a type of therapy in which the hormones which are depleting in the body are replaced externally through medicines. They can be given in the form of patches, creams, gels, tablets, injections or surgically inserted. It is prescribed in post menopausal women to reduce the symptoms of menopause. Most successfully used in the prevention of osteoporosis. It has been widely used for prevention of cardiovascular disease in women too but its effect on this is still debatable and needs further investigation.  Also, it may increase the risk of endometrial cancer or others.
Lifestyle changes:
Prevention is the best medicine for cardiovascular disease. Exercising regularly can really make your heart healthy and fit. Eating right is another factor which we have control over. Avoiding fatty foods, low density cholesterol and increasing fresh fruits and vegetables in our dietary routine can reduce the risk of cardiovascular disease. Smoking leads to heart disease and quitting smoking and never starting can prevent you from this deadly disease. Stress also puts extra load on your heart and by managing stress you can make your heart work less. Getting early diagnosis is also a form of prevention. So, never skip your routine medical checkups. Regularly monitoring blood pressure and taking medicines if needed to control it can prevent cardiovascular events very efficiently. Education is also very important. Knowing about your heart and the alarming signs can help you get the best treatment at best time.

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