Mid-life and Menopause Heart Disease and Why Sex Matters?
February is the American Heart Association's GO RED FOR WOMENannual campaign focused on raising awareness of heart disease as the No. 1 killer of women. This gender-based campaign has led to a significant reduction in rates of death among women. Paying attention to preventing heart disease needs to start long before menopause and may need to start after having a first child. Despite this heightened awareness, only 45% of women identify heart disease as their leading cause of death. Fewer then 50% of primary care doctors consider cardiovascular disease a top concern in women, after breast health and weight. FACTS ABOUT HEART DISEASEare that 1 in 3 women die from heart disease whereas 1 in 31 die from breast cancer. Ninety percent of women with at least one risk factor for cardiovascular disease need to understand that prevention strategies begin decades before clinical heart disease is apparent.
Traditional RISK FACTORSfor cardiovascular (CV) disease such as high blood pressure, diabetes, high cholesterol, and obesity affect both sexes but some may affect women differently and are considered to be more potent.
Non-traditional risk factors, unique to or predominant in women, include auto immune disorders like rheumatoid arthritis, lupus, and scleroderma. Breast cancer predominantly affects women, and its’ treatments increase the risk of CV disease.
Sex specific risk factors are related to pregnancy and ovarian hormonal influences. Adverse pregnancy outcomes (APO’s) are important predictors of future cardiovascular disease. Complications that arise in pregnancy considered to be APO’s include preeclampsia, gestational diabetes, pregnancy associated hypertension, preterm delivery, and low for estimated gestational age birth weight. Having any one of these diagnoses increases a woman’s future risk for cardiovascular disease. Use of birth control pills does not increase cardiovascular risk. Reproductive women with polycystic ovarian syndrome (PCOS) have a high risk for type 2 diabetes which when poorly controlled can increase cardiovascular risk.
American Heart Association Simple 7are the components of a daily strategy for a heart healthy lifestyle if you even have one cardiovascular risk factor. Know your blood pressure and be aware that greater then 130/80 is elevated, so check it regularly with a home BP cuff. Know your blood glucose (Hg A1C) and cholesterol levels (HDL/LDL/ Triglycerides) with the help of your PCP.
Lifestyle interventions that lower your CV risk include physical activity150 min/wk. averaged over 5 days, nutritional counseling(eating more whole grains and plants) and stress reductionwhich can include a combination of medication, mindfulness training or seeing a therapist regularly. Schedule an appointment with your PCP or OB/Gyn to see if this is something they actively treat or needs specialty referral. The menopausal blog section of at our website, leachobgyn.com, has the underlined hyperlinks to the American Heart Association’s web content.