Menopause and cardiovascular disease – Risk factors, tips to keep your heart healthy

Zee Media Bureau

Menopause, also known as the climacteric, is the stage in a woman's life when her menstrual periods stop permanently, signaling the end of her reproductive years.

It happens when there are no more eggs in your ovaries. Because eggs stimulate your body to produce oestrogen, the levels of oestrogen in the blood drop, resulting in menopausal changes in the body when they are exhausted.

It usually occurs naturally, most often after 45 years of age. However, it can happen earlier in those who smoke tobacco.

Symptoms

As a result of the hormonal changes surrounding menopause, many women experience both physical and emotional symptoms:

• Hot flushes / flashes
• Night sweats
• Insomnia and disrupted sleep
• Racing heart / palpitations
• Weight gain (especially around the waist and abdomen)
• Headaches
• Changes to the skin, hair and nails
• Aches and pains in joints and muscles
• Lower sex drive
• Vaginal dryness, pain during sexual intercourse and increased risk of vaginal infections
• Inability to control urination and increased risk of urinary infections
• Difficulty concentrating and memory lapses
• Fatigue / low energy levels
• Mood swings and irritability
• Depression

While menopause is a perfectly natural occurrence, the decreased levels of oestrogen and other hormones can lead to the above symptoms, as oestrogen has an effect on almost every tissue in the body.

Menopause and heart disease

It is observed that oestrogen helps protect women against heart disease. During menopause, as oestrogen levels drop, the level of fat in a woman's blood can increase. These changes put women at risk for developing heart and circulatory system disorders such as high blood pressure, high cholesterol, stroke and heart disease.

“It is always believed that men have a higher risk of developing cardiovascular disease. This is true for men & women between 40-50 years, but once a woman goes beyond her menopause, she is at an equal or sometimes higher risk of the same problem,” Dr Duru Shah, Director, Board of the International Menopause Society, said.

“Although it is a disease of aging, vascular disease initiates much earlier in life. Thus, there is a need to be aware of this possibility, in order to prevent the development of the disease at an older age. When a woman visits her gynaecologist for her routine gynae examination, it presents an ideal opportunity to assess her cardiovascular risk and plan accordingly,” Dr Duru Shah added.

Risk factors for heart disease

Risk factors are conditions or a lifestyle that make a person more likely to develop a disease. They can also increase the chances that an existing disease will get worse. Important risk factors for heart disease that you can proactively manage are:

• Raised blood pressure
• Raised blood cholesterol
• Diabetes and prediabetes
• Smoking
• Excessive alcohol consumption
• Being overweight or obese; unhealthy diet
• Being physically inactive
• Having a family history of early heart disease
• Age (55 or older for women)

Some risk factors, such as age and family history of early heart disease, cannot be changed. However, there are som factors that you can change or control such as your weight, your blood pressure, your cholesterol, what you eat and drink, if you smoke and how much exercise you do.

While the individual effect of each risk factor varies between different communities or ethnic groups, the overall contribution of them is very consistent, and thus many important cardiovascular risks are modifiable by lifestyle changes.

For women, age becomes a risk factor over the age of 55. After menopause, women are more likely to get heart disease, partly because their body's production of oestrogen drops.

Besides, women who have gone through early menopause, either naturally or because they have had their ovaries removed are twice as likely to develop heart disease as women of the same age, who have not yet reached menopause.

Prevention tips for heart disease in later life

The menopausal phase in a woman’s life is an important window where preventative measures can be most effective with the right intervention. Dr Duru Shah suggested some tips on how to prevent heart disease in later life:

• Stop smoking and avoid second hand smoke.
• Reduce alcohol consumption and follow the recommended daily limits. Excessive alcohol intake increases the risks of heart disease.
• Regular aerobic exercise upto 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 of fruits and vegetables a day reduce risk by about 25%.
• Control of body weight if overweight or obese.
• Consider menopausal hormone therapy in pre-menopausal women younger than 60, not help to manage hot flushes and other symptoms of the menopause transition but also potentially, to help prevent heart disease.
• Lower blood pressure if elevated.
• Decrease cholesterol.
• Decrease psychosocial stress- Mental stress-induced myocardial ischemia is associated with an increased risk of heart problems in those with previous heart disease.
• Seek expert medical advice.

World Menopause Day is celebrated on October 18 and is a worldwide awareness call for women who face health issues when menopause day comes. On this day, the International Menopause Society (IMS), in collaboration with the World Health Organisation (WHO), has designated to focus on menopause, from hot flashes to heart health, and all things menopausal.

The theme for World Menopause Day 2016 is “Heart Health Matters”, in which the campaign highlights the opportunity of using the menopausal period to assess female-specific risk factors and prevent the development of cardiovascular disease.