08/03/2003 - Articles

Women: Consider Heart Healthy Changes Before the 'Change'

By: Tufts University


Cardiovascular disease: not for men alone

Often thought of as a 'man's disease,' cardiovascular disease represents a major health threat to women as well. In younger women, the hormone estrogen provides a level of protection. However, estrogen levels drop at menopause. This, along with other factors that often accompany aging such as weight gain, causes the risk of cardiovascular disease for women to rise sharply following menopause.

Because of this increased risk, efforts to address cardiovascular risk factors are often stepped up during menopause. Evidence from a study appearing in a recent issue of the journal Stroke, however, indicates that earlier intervention may be more effective.

Researchers from the University of Pittsburgh in the United States evaluated 372 relatively healthy women prior to menopause, one year after their menstrual cycles stopped, and after five years. The evaluation included measurements of such cardiovascular risk factors as HDL ("good") and LDL ("bad") cholesterol, triglycerides (the main form in which fat travels through the blood vessels), glucose, blood pressure, body weight, and body mass index (BMI, a measure of weight relative to height).

Five or more years after menopause, most of the women also underwent an ultrasound of their carotid arteries. This procedure measures thickening and plaque deposits in the arteries in the neck, and provides an overall indication of the state of blood vessels. Increased thickening and plaque deposits are associated with a higher heart attack and stroke risk.

Adverse changes occur early

The researchers found a substantial and statistically meaningful increase in all risk factors except HDL cholesterol over the follow-up period. Changes in LDL cholesterol, triglycerides, and BMI were greatest in the time from premenopause to the first year after menopause. On average the women's LDL cholesterol rose about 20 milligrams from the premenopausal to the fifth year postmenopausal measurement. Those women who had higher cholesterol and blood pressure and increased body weight before menopause also showed increased thickening and blockages in their carotid arteries in later years.

Reducing the risk of cardiovascular disease

Evidence from this study indicates that women probably should commit to heart healthy strategies such as controlling their weight, engaging in regular physical activity, and following a heart healthy diet in their younger years. Notably, while later blood vessel damage was linked to elevated premenopausal levels of cholesterol, blood pressure, and weight, these values still fell within what are considered to be normal limits.

According to the American Heart Association, cardiovascular disease, including both heart disease and stroke, accounts for 43% of all female deaths in America and in most developed countries. Taking steps to reduce your risk of cardiovascular disease is important at any age, but it is easier to build good habits early than to try to make changes later on.


Changes in cardiovascular risk factors during the perimenopause and postmenopause and carotid artery atherosclerosis in healthy women.
KA. Matthews, LH. Kuller,  et al., Stroke, 2001, vol. 32, pp. 1104--1111


Created on: 07/25/2001
Reviewed on: 08/03/2003

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