18-02-2025
Menopause is not good for your heart. What Round Rock cardiologist said you should know.
When many people think about that transition into menopause, they might consider symptoms such as hot flashes, night sweats, brain fog, depression and mood changes.
They also should think cardiovascular disease such as heart attacks and stroke. Heart disease is the No. 1 cause of death among women, and their risk as they hit menopause is similar to men of the same age.
That transition as menopause is happening increases a women's cardiovascular death risk, and about 50% of menopausal women have an increased risk of cardiovascular disease during this period, said Dr. Aditi Shankar, a cardiologist at Baylor Scott & White in Round Rock.
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During the reproductive age, women have a relatively low risk for heart disease because of all the reproductive hormone levels, said Dr. Aditi Shankar, a cardiologist at Baylor Scott & White in Round Rock. It's not just the estradiol that decreases, but also other heart-protecting hormones. Meanwhile, the form of estrogen known as estrone actually goes up. It does not have heart protective qualities.
As those heart protection hormones decrease, it affects the cholesterol in your blood stream. With less estradiol and protective hormones, the bad cholesterol (LDL) is increased and the good cholesterol (HDL) decreases. The bad cholesterol jams up the works and creates a blockage in the arteries and blood vessels, causing a heart attack or stroke.
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The average woman hits menopause at age 50, but anything between 48 and 53 is considered normal. Women who hit menopause before age 45 either naturally or through surgical means such as a hysterectomy have an increased risk of heart disease because they have more years without the cardiovascular system-protecting hormones.
Especially beginning in perimenopause, that time period in which symptoms are beginning to be felt, women need to "start aggressive prevention," Shankar said.
Decrease the size of their waist to less than 35 inches. Abdominal fat around the organs has been linked to an increase risk.
Maintain a healthy HDL cholesterol of more than 50 milligrams per deciliter, and maintain a LDL of less than 100 milligrams per deciliter.
Maintain a fasting blood sugar level of 100 milligrams or less, and a healthy A1C (the blood glucose level over a three-month period) of 5.7% or less.
Regulate your blood pressure. Normal is 120/80.
Make sure your thyroid levels are well-maintained.
Maintain a healthy weight of less than 25 body mass index.
Exercise 115 minutes a week of moderate exercise to 75 minutes of intense exercise.
Use a diet that is low in saturated fats, low in added sugar, low in sodium (2,000 milligrams or less) and high in fruits and vegetables, healthy grains and lean proteins such as the Mediterranean or the DASH diet (Dietary Approaches to Stop Hypertension).
Limit alcoholic beverages to no more than one drink a day on average, or for cancer risk reduction, less than that.
Do not smoke, including vaping.
Consider doing a CT screening after age 45 to assess the amount of calcium buildup around your heart.
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The hormones you replace are not as protective as the hormone's you used to naturally produce, Shankar said. In fact, there is some evidence that after menopause, these synthetic hormones can increase your heart disease risk factor instead of decreasing it, she said.
It would be better to start a cholesterol-reducing statin, and medicines to control high blood pressure and blood sugar, rather than hormones.
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It is not the same as in men, who typically feel like an elephant is sitting on their chest.
In women, in addition to chest pain, a heart attack can feel like:
Pain or pressure in the lower chest or upper abdomen
Jaw, neck or upper back pain
Nausea or vomiting
Shortness of breath
Fainting
Cold sweat
Indigestion
Extreme fatigue
This article originally appeared on Austin American-Statesman: Menopause increases heart disease in women, Austin area experts say
