You will notice I talk a lot about heart health. I do for good reason. As shared by the Heart and Stroke Foundation of Canada, Cardiovascular disease is the leading cause of premature death in women in Canada. Considering this, I am hoping we can focus on Cardio Prevention or Heart Health in many conversations.
What can we do?
Heart health includes an awareness of your personal and family history, attention to modifiable risk factors, and taking an active role in preventative measures. The goal is to try to reduce ones risk of heart disease through lifestyle changes, regular monitoring and early intervention.
Things you can do at home include following a heart healthy diet like the Mediterranean diet, high in plants, low in saturated fats and low in/ without processed foods among other practical recommendations found here.
Other things you can do is avoiding smoking, staying active, and focusing on your mental health. The Canadian Women’s Heart Health Alliance is an excellent resource for more information click here.
The Heart and Menopause:
Estrogen and progesterone changes in your body during menopause related to the heart and menopause are complex. Hormone therapy and heart health is also layered and involved. When hormone therapy is started under the age of 60 and within 10 years of menopause, there may be some benefit of hormone therapy in some women AND for other women, there may be no effect. However, far more research is needed in this area. At this time, hormone therapy should not be considered cardio protective, women should have their individual risk assessed for appropriateness of hormone therapy and should be monitored over the course of use if that is the shared decision made by health care provider and you – the woman.
The Window of Opportunity:
It has been found in numerous trials and years that there is a window of opportunity when it comes to the use of hormone therapy and cardiovascular disease. This window includes age (under the age of 60) and time since FMP (within 10 years of your final menstrual period). Talk to your provider about this and your personal safety and risks.
As per the 2022 Menopause Society Statement :
“For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the benefit-risk ratio is favorable for treatment of bothersome VMS and prevention of bone loss. For women who initiate hormone therapy more than 10 years from menopause onset or who are aged older than 60 years, the benefit-risk ratio appears less favorable because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia”
The Heart and Age:
Cardiovascular disease increases with age. Estrogen deficiency is intertwined in this change however the use of estrogen for cardio protection has not been proven to be an appropriate recommendation due to the outstanding evidence and uniqueness of cardiac risks including family history.
Heart Health and your Journalling of your Health:
It is important to make sure you know your Blood Pressure, cholesterol and blood sugar to identify and manage risk factors early if needed. You should speak to your health care provider about your testing and management if required.
Heart Health and Wellness:
Risk factors for heart disease include stress, anxiety and depression which can all negatively impact cardiovascular health. Stress can be a direct negative impact through physical stress or indirectly through lack of physical activity and / or heart healthy food and social choices like smoking that negatively impact cardiac health. Some suggestions in managing this include relaxation techniques, regular exercise, surrounding yourself with supportive people, and taking part in therapy as well as medication as needed.