Heart disease is one of the leading causes of death in Australia. For women, the risk of heart disease rises around menopause. Here, we look at why the hormone oestrogen matters and the best ways to care for your ticker at midlife.
Most of us know that eating well and exercising regularly are great for our heart. But what you mightn’t know is that the hormone oestrogen is another key player in the heart health game.
Oestrogen is not only important for periods, pregnancy and bone health. It can also help keep your cholesterol levels in check, according to Professor Garry Jennings AO, Chief Medical Advisor at the Heart Foundation.
The hormone is believed to be one of the reasons younger women are somewhat protected from heart disease – they have relatively high levels of oestrogen. However, come menopause, oestrogen levels naturally fall and a woman’s risk of heart disease increases.
According to Professor Jennings, this drop in oestrogen can lead to a rise in ‘bad’ LDL cholesterol and fall in ‘good’ HDL cholesterol.
It’s also worth mentioning that women’s hormone levels aren’t the only factor affecting heart health at midlife. Professor Jennings says that blood vessels can become less flexible and more prone to plaque build-up. “Together, these changes can lead to high blood pressure and sometimes high blood sugar (glucose) levels, which are important risk factors for heart disease.”
Weight gain generally occurs around this time, which can have an impact too, adds Dr Sonia Davison, an endocrinologist at the Jean Hailes Clinics. “It tends to be around the abdominal or tummy region, and is linked with increased risk of heart disease,” she says.
Then there’s the effect of menopause on exercise levels. In an ideal world, we’d keep the heart in good shape with plenty of physical activity. But, according to Dr Davison, “those women who have bothersome menopausal symptoms that impact mood or sleep may do less exercise as they may not feel up for exercise”.
A heart health check is an appointment you have with your doctor to check your risk of having a heart attack or stroke. The Heart Foundation recommends a regular check from age:
But Professor Jennings adds you should see your doctor for a heart health check earlier if you have a family history of heart disease at a young age or any of the ‘women-specific’ risk factors for heart disease. “These include premature or early menopause, polycystic ovary syndrome (PCOS), or a history of pregnancy conditions like pre-eclampsia or gestational diabetes.”
A visit to the doctor is often on the to-do list for midlife women because of issues such as menopausal symptoms or other health checks. Dr Davison says women should take advantage of this time with their doctor and ask about heart health too. “Menopause is a great opportunity to talk about cardiovascular health and plan for the future,” she says.
Besides getting a heart health check regularly, Professor Jennings recommends healthy habits to keep your heart in good shape. “These include following a heart-healthy eating pattern, being physically active, quitting smoking, cutting down on alcohol and maintaining a healthy weight.
“Looking after your mental health is also important for heart health because we know depression and anxiety are risk factors for heart disease”. This is partly because it can be difficult to maintain heart-healthy habits, like regular exercise, when you are struggling mentally.
Ultimately, Dr Davison says it’s about understanding your risk and finding healthy ways to reduce that risk.
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