The menopause is a risk factor for cardiovascular disease

Cardiovascular disease – mainly heart attack and stroke – is the biggest killer of women in Ireland, yet research carried out by the Irish Heart Foundation showed that less than one in five Irish women were aware of this.

Oestrogen seems to have a protective effect on the heart however as women get older and enter the menopause their risk of cardiovascular disease increases. However, the same Irish Heart Foundation research revealed that only one in four women in Ireland knew about this increased risk.

According to Dr Angie Brown, Medical Director, Irish Heart Foundation, “most women think they are going to die from breast cancer when in fact they are six times more likely to die from cardiovascular disease.”

The symptoms of heart attack in women can be quite vague making it hard to diagnose and that is why heart attack and heart disease is often missed in women. A woman can have nausea, tiredness, shortness of breath, back pain or tightness in the jaw rather than the more familiar scenario of a crushing pain in the chest that shoots down one arm.

A decline in oestrogen levels is thought to be a factor in the increase of heart disease among post-menopausal women. Oestrogen is believed to have a positive effect on the inner layer of artery wall, helping to keep blood vessels flexible. That means they can relax and expand to accommodate blood flow. Lack of oestrogen also affects the lipid profile adversely increasing the bad fats (LDL). Once the menopause hits generally around the age of 50/51 and oestrogen levels decline, women no longer have the benefits of natural oestrogen leaving them at risk of heart disease.

Therefore, women tend to present with heart problems a few years later than men as after the menopause a woman’s risk of heart disease catches up with that of a man’s.

Factors such as smoking, being overweight or obese, having high blood pressure, high cholesterol, being inactive and or having diabetes or a family history of heart problems all increase the risk of heart attack and stroke and Dr Brown explained that in many cases women are more vulnerable to these factors than men.

“For example, women metabolise nicotine a lot faster than men, so a cigarette will increase a woman’s risk a lot more than it will in a man. The same with diabetes- it increases a woman’s risk of having heart disease a lot more than it will for a man. Another risk factor that is more important for women is family history of heart disease, which can be a stronger predictor in women than in men,” Dr Brown stated.

After the menopause, factors such as being overweight, having high levels of bad cholesterol and high blood pressure become more pronounced and obesity further increases the risk of developing diabetes.

“Cardiovascular disease is going to start years in advance,” said Dr Brown.

“It’s usually not the fancy stuff that makes you live longer, it’s always about the basics: weight, cholesterol, keeping diabetes away and not smoking. The good news is that 80 per cent of cardiovascular disease is preventable.”

ENDS