UNC Health Care
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Menopause and Your Heart

As if hot flashes, mood swings and insomnia weren’t bad enough, women can add an increased risk of heart disease to the list of concerns they may face as they reach menopause.

It’s important to note that menopause doesn’t cause heart disease, but heart disease can become more likely after the onset of menopause.

“It is known that women pre-menopause are at lower risk of heart disease and stroke compared to men, and then after menopause that risk goes up,” says UNC cardiologist Christopher Kelly, MD.

Researchers are still exploring this connection, but they think the natural decline in the hormone estrogen may play a role. Estrogen may have a protective effect for women, though exactly how it works is still unknown, Dr. Kelly says.

Here’s what we do know: Estrogen is thought to help keep blood vessels around the heart flexible. That means they can relax and expand so blood flows through easily, resulting in lower blood pressure. Estrogen also increases the level of good cholesterol and reduces the level of bad cholesterol.

As menopause nears, ovaries make less estrogen, so the protective effect estrogen has on the heart decreases and a woman’s risk of heart disease goes up.

“It seems like whatever the protective effect is, it goes away after menopause,” Dr. Kelly says.

So if estrogen decreases after menopause, should you take estrogen supplements to lower your risk? Surprisingly, no. It turns out that taking hormone supplements after menopause may increase your risk of stroke and heart disease.

“Even though it seems counterintuitive, if women take estrogen pills after menopause, they may face an even further increased risk of having a heart attack or a stroke, primarily if they are many years out from menopause,” Dr. Kelly says. “The risk is much lower right after menopause, when hormone supplements may be helpful for reducing menopausal symptoms.”

There are steps you can take to lower your risk of heart disease after menopause:

  1. Control your blood pressure. High blood pressure is a major risk factor for heart disease. Get your blood pressure checked at least once a year and more often if you have high blood pressure. If you have high blood pressure, take steps to reduce it.
  1. Keep your cholesterol under control. High levels of cholesterol can clog your arteries and raise your risk of coronary artery disease and heart attack.
  1. Don’t smoke. Cigarette smoking raises your blood pressure and increases your risk of heart attack and stroke. If you smoke, quitting will lower your risk of heart disease.
  1. Get your annual flu shot. Influenza (the seasonal flu) has been linked to increased heart attacks and strokes, Dr. Kelly says.

“Get your flu vaccination to reduce your risk of having influenza and also to reduce your risk of having a severe infection if you do get the flu,” Dr. Kelly says.

  1. Practice moderation when it comes to food and drink. Eating a diet high in saturated or trans fats is linked to heart disease, and too much salt and alcohol can raise your blood pressure, which also taxes your heart. Chronically elevated blood pressure means your heart has to work harder than it should to circulate blood throughout your body.

It’s not easy, but try to practice moderation and eat heart-healthy foods. Choose whole grains, fruits and vegetables, and watch your sodium intake.

  1. Exercise regularly. Cardiovascular exercise (walking, running, swimming, dancing) can strengthen your heart and improve your circulation. It also can help you maintain a healthy weight and lower your cholesterol and blood pressure.
  1. Get enough sleep. Most adults need seven to nine hours of sleep per night. If you don’t get enough sleep, it can increase your risk of high blood pressure, obesity and diabetes—all of which can raise your risk of heart disease.
  1. Understand the signs of a heart attack. Women having a heart attack are more likely to experience symptoms other than chest pain.

Common symptoms of a heart attack in women include:

  • Fatigue or weakness
  • Unusual tiredness
  • Sudden dizziness
  • Pressure or tightness in the center of the chest
  • Pain that spreads to the upper body, neck or jaw
  • Unusual sweating, nausea or vomiting
  • Shortness of breath
  • Problems sleeping

“Become educated about what symptoms could indicate a heart problem, and make sure you get appropriate medical attention if you experience them,” Dr. Kelly says.

If you experience these symptoms, don’t ignore them. Play it safe and call 911. The sooner you get treatment, the greater your chances of recovery.


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Photo credit: (Heart Disease) ©AleksandarNakic – gettyimages.com