Menopause-Related Hormonal Changes Linked to Increased Heart Risk in Women
Cardiovascular diseases in women now outnumber breast and uterine cancer. According to data from the World Health Organization, one third of deaths worldwide are caused by these problems, accounting for 23,000 deaths of women per day.
Incidence in Brazil
In Brazil, heart disease in women can account for 30% of the causes of death, the highest rate in Latin America. Heart problems increase for several reasons, but are mainly related to hormonal changes and their effects on the body.
“Estrogen has a protective effect on the cardiovascular system. It helps keep blood vessels flexible and promotes the protective effects of the cardiovascular system. Menopause causes an increase in cholesterol and triglycerides, leading to dyslipidemia, increased blood pressure, weight gain and fat redistribution. Fat accumulates in the abdominal region, which is known to have a higher risk of cardiovascular disease. In addition, menopause can lead to a decrease in insulin sensitivity, increasing the risk of developing type 2 diabetes; inflammation and oxidative stress are also associated with menopause, leading to the progression of atherosclerotic disease,” highlights Walquíria Samuel Ávila, coordinator of the Heart Disease, Pregnancy and Reproductive Counseling Program at Incor – the Heart Institute of the State of São Paulo.
At this stage of life, the doctor highlights, women in menopause present risk factors and worse lifestyle changes: such as a sedentary lifestyle, inadequate diet, increased stress, and all factors combined explain why menopause is a critical period for women’s cardiovascular health.
Check-up and symptoms
When a woman has risk factors such as family history, hypertension, diabetes or obesity, these assessments should be carried out from the age of 30 and should be mandatory in pre-menopause, 40, 50 years of age and in menopause, after 50 years of age. Walquíria emphasizes that “regardless of age, it is important for all women to have regular medical check-ups, including cholesterol, glucose, blood pressure and other well-known cardiovascular health indicators”.
Women may experience different symptoms than men during a cardiovascular event, so it is important to recognize the symptoms. Women often underestimate the severity of their symptoms, attributing them to less serious conditions such as stress or digestive problems. In addition, sometimes the symptom of a heart attack can be severe back pain, jaw pain, or even pain in the upper abdomen.
The main heart problems that can affect women are: first, hypertension, high blood pressure, diabetes, dyslipidemia (which is a change in cholesterol), obesity, chronic kidney disease, obstructive sleep apnea, inflammatory and autoimmune diseases such as rheumatoid arthritis and lupus, a sedentary lifestyle, a family history of chronic stress, excessive alcohol use and smoking. These are factors that can, in addition to menopause, lead to cardiovascular disease and other problems that can trigger cardiac events in addition to menopause.
Exams
Several tests can help detect heart problems. “Among the most common, the first step is to check your blood pressure, lipid profile, LDL, HDL and cholesterol levels, blood sugar, glycated hemoglobin, an electrocardiogram, an echocardiogram, a stress test for those who do physical activity, and so on. There are several tests that will be performed according to the doctor’s recommendation for each patient.”
The problem is so serious that, in order to prevent cardiovascular problems, Incor has a program that began in 2019 called Women, Take Care of the Heart. This prevention work uses a multidisciplinary, multifaceted approach that can include lifestyle changes, medications, and interventions. The Mediterranean diet, salt reduction, limitation of saturated and trans fats, increased fiber intake, physical activity, not only aerobic exercise, but also resistance strength training, weight control, avoiding smoking, moderating alcohol consumption, and drug treatment that will be suitable for each type of patient, for each type of clinical situation, which should be considered in their periodic check-ups, advises the coordinator of the Incor Heart Disease, Pregnancy, and Reproductive Counseling Program.