Cardiovascular Disease Risks Accelerate During Menopause Take Action Now to Help Your Patients!

Cardiovascular Disease Risks Accelerate During Menopause 

Take Action Now to Help Your Patients!

 

 

 

Cardiovascular disease (CVD) is the leading cause of death in women over age 50, yet most are unaware of their risk. Only 22% of primary care providers and less than half of cardiologists surveyed in a recent study reported feeling prepared to assess CVD risk in midlife women. Most postgraduate medical students surveyed had received no training in sex-specific risk factors for CVD. Women are still slipping through the cracks with undetected CVD and dying without any previous diagnosis or treatment. What can you do as a healthcare provider? A LOT!

 

 

 

 

The American Heart Association (AHA) recommends eight key health behaviors to detect cardiovascular disease called “The Essential Eight.” Here are the Big Eight:

 

  1. Body mass index, fat distribution, and body composition. Women gain an average of 10 pounds during the menopause transition, primarily due to adopting a less active lifestyle over time. The big risk is redistribution of body weight due to hormonal changes, with more visceral fat accumulation in the abdomen. Many women develop an “apple shape” appearance that is associated with greater CVD risk. 
  2. Lipids. Starting a year after the final menstrual period, many women experience sharp increases in cholesterol, especially high-density lipoprotein (HDL) that increases CVD risk.
  3. Blood pressure and vascular function. Carotid arteries tend to thicken after menopause, an early marker of atherosclerosis and arterial stiffness, both contributors to CVD. Blood pressure is generally lower in women than men prior to menopause. However, after menopause, many women experience a sharp increase in their systolic blood pressure that places them at increased risk for CVD, even if their blood pressure is still within AHA guidelines. 
  4. Insulin and glucose metabolism. Insulin resistance increases after menopause. Add that to weight gain and unhealthy dietary habits, and the risk for metabolic changes such as diabetes also increases.
  5. Early age at menopause. Women who go through menopause early, under age 45, are at higher risk for developing CVD. While age of menopause isn’t modifiable, it is an independent risk factor that can be mitigated if screened early.
  6. Frequent vasomotor symptoms (VMS). Frequent severe hot flashes and night sweats may indicate increased risk for unhealthy levels of lipids, increased blood pressure,j and risk for development of metabolic diseases associated with CVD risk.
  7. Estrogen and menstrual patterns. Women who experienced fewer changes in menstrual cycles and had consistently low levels of estrogen during and after menopause may be at higher risk for later development of CVD than women who had longer menstrual cycles during menopause transition with fluctuating high levels of estrogen followed by a sharp decline after the final menstrual period.
  8. Menopause Hormone Therapy (MHT). Menopause hormone therapy lowers CVD risk in women who have had premature menopause and does not appear to increase CVD risk in women who initiate MHT prior to age 60 or within 10 years of menopause. CVD risks do increase with age for women taking MHT so women over age 60 or more than 10 years past menopause should discuss their individual risks and benefits for continuing MHT with their healthcare provider.

 

 

 

 

If you are a healthcare provider, are you screening your patients? Every woman should be screened for CVD risks regardless of why they are seeing you because most risks can be reduced with education on lifestyle changes. Screening is quick and easy. We provide you the tools and education to help your patients live longer, healthier lives. Isn’t it time to learn how?

 

 


Tags

estrogen, healthy lifestyle, heart disease, heart disease risk, heart health, hormone therapy, lifestyle, menstrual cycle, women's health


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