Most women are well aware of the threat that breast cancer poses, especially as they approach menopause. Ask them about heart disease, however and they’ll tell you that is something for their husband/partner to worry about. Contrary to popular belief, however, heart disease is not just a man’s disease. As the number one killer of women over the age of 25, heart disease kills ten times more women than breast cancer does and, in fact, more women die of heart disease than as a result of all female cancers put together.
Once a women reaches the age of 50 (around the age of natural menopause), the risk of heart disease increases significantly. This happens for the following reasons:
- Oestrogen helps protect a younger woman’s body from heart disease.
- Changes in the walls of blood vessels make it more likely for plaque and blood clots to form.
- Changes in levels of lipids (fats) in the blood are a risk.
- An increase in fibrinogen (which helps blood to clot) is related to heart disease and stroke.
While all of the above makes it incredibly important for women entering menopause to check their heart health, those who unknowingly enter early menopause are in even greater danger. A study published in the October issue of the journal Menopause shows that women who experience early menopause, either naturally or due to the surgical removal of their ovaries, may face double the risk of heart disease.
The results of this study suggest that lifestyle choices which may result in early menopause must be taken into serious consideration. Smokers, for example, reach menopause on average two years earlier than non-smokers, and quitting may delay menopause. Other factors that may influence the onset of menopause include diet and exercise.
An additional consideration when it comes to heart disease risk during menopause is the role of hormone replacement therapy (HRT) to prevent heart disease, which is controversial. Initial research indicated that HRT could possibly reduce the risk of heart disease in women, but more recent large scale studies have shown an increased risk of breast cancer, coronary heart disease, stroke, blood clots and gall bladder disease amongst women using HRT. Based on these results, The American Heart Association does not recommend HRT to reduce the risk of heart disease or stroke.
Which begs the question, is HRT safe?
Short-term hormone replacement therapy for symptom relief is safe for women. However, before HRT is started, women must be sure to have their medical history reviewed with their healthcare provider. Your assessment at the onset of menopause should not just include a pap smear, mammogram, bone density scan, but a full heart assessment as well, at the very a minimum.
With the very real and largely unknown risk which heart disease poses for women, especially those entering menopause, South African women have for some time not been well-served when it comes to addressing their heart health. The Woman’s Heart Clinic, based at Melrose Arch, is a first for South Africa. It is the first clinic established to address the impact of hormonal changes on the heart and looks at heart disease in women in an integrative fashion, employing both conventional and natural means of treatment.
Written by Dr Riaz Motara, specialist physician/cardiologist of The Heart Wellness Centre in Gauteng. For more information on heart health visit www.heartwellness.info
- (Health24, October 2012)