Menopause Concerns: Risks And Treatments Of Cardiovascular Disease In Women

There has been a great deal of controversy about the increase in cardiovascular disease in menopausal women.

Besides signaling the end of a woman's reproductive life, menopause can also indicate the point at which she becomes increasingly at a greater risk of having a heart attack or other cardiovascular disease. Prior to entering menopause, the rate of heart attacks in women is three times less than in men.But, as a woman ages, her risk for heart attack increases, and, by the time she reaches the age of 65, her risk factor equals that of a man.In fact, cardiovascular disease is now the leading cause of death in women.

What is surprising is that, not only are there many women who do not know they are at risk, there seem to be a lot of physicians who are equally unaware.One reason for this is that the symptoms of a pending heart attack in women present differently than those in men.In women, symptomatic pain may present in the shoulders, neck, or jaw, rather than the chest as is typical in men.Nausea, shortness of breath, dizziness, and fatigue may also be symptoms of heart problems in women.Additionally, heart attack is still considered a "man's disease."Clearly, the public needs to be educated in this area.

Another factor that has impacted the onset of cardiovascular disease in women has been certain types of hormone replacement therapy (HRT).In July 2002, the National Heart, Lung, Blood institute made a startling announcement.This agency had been conducting a study that was known as the Women's Health Initiative.Menopausal women in the trial were being administered a combination of estrogen and progestin as a treatment for menopausal symptoms.The study was discontinued when participants began to show an increase in breast cancer and blood clots.Additionally, some women taking this combination of drugs were suddenly finding themselves at a higher risk of heart attack and strokes.The study was continued using only an estrogen based treatment, but, in March 2004, the National Institute of Health called off this study as well after determining that estrogen also seemed to increase the risk of stroke, and there was no significant reduction in the incidence of heart disease among participants.


These developments lead to changes in the American Heart Association's "Guidelines for Cardiovascular Disease Prevention in Women."This guideline stated, in no uncertain terms, that these HRTs were not effective in preventing cardiovascular disease and/or stroke in women who are postmenopausal.They also recommended that alternative treatments be used, and that HRTs only be administered in extreme cases.Their deduction - estrogen, with or without progestin, does not prevent heart disease or stroke.

This, of course, left millions of women with no form of treatment for their menopausal symptoms, and no clear guidelines for preventing cardiovascular disease.Doctors, who had routinely been administering this type of therapy, were also concerned about what to prescribe for their patients. Many women found that discontinuing HRT forced them to deal with their symptoms again, and were further burdened with concern about preventing heart disease.

Doctors do agree that lowering cholesterol and blood pressure, exercising, discontinuing smoking, and eating a healthy diet are key to prevention.There are also some medications that have proven to be effective in preventing or treating cardiovascular disease.Aspirin, beta-blockers, and ACE-inhibitors can all be effective. Of course, every woman is different, and, other factors, such as family history, diabetes, stress and hypertension can also contribute.

For menopausal and postmenopausal women, the best prevention for cardiovascular disease is an increase in the level of physical exercise.There is just no way around this.Studies have shown that by walking for just 30 minutes, three times a week, a woman can reduce her risk of heart attack by 50 percent.Not only does exercise benefit the heart; it also helps in controlling the weight gain that can accompany menopause.Maintaining a comfortable body weight also contributes to a healthier heart.

Smoking cessation is also critical in the prevention of cardiovascular disease in women.Only two years after a woman quits smoking, she has cut her risk of heart attack by one third.Combine that with exercise, and the risk is reduced even further.It is difficult, but the rewards are a healthier heart, reduced risk of lung cancer and other lung diseases.The benefit is also increased lung capacity, and, with that, the ability to exercise more comfortably.There are also studies that indicate smoking may exacerbate menopausal symptoms such as hot flashes and night sweats.

Menopause can be a positive change in a woman's life.Certainly, a woman who takes control of her health at this critical juncture can be assured of living a longer, happier and healthier life.

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