Cardiac & Bone Health
How to maintain healthy heart and healthy bones after menopause
The incidence of heart disease increases with age and in women there is an additional risk due to menopause consequent to the loss of ovarian function.
Menopause may be considered as a biological marker for heart disease.
Cardiovascular disease is the leading cause of mortality in women after menopause.
Modifiable risk factors for cardiovascular disease are
- Central obesity
- High blood pressure
- Lower physical activities are on the risk.
Life style changes can potentially prevent up to 80% of heart disease, 90% of type 2 diabetes.
There is an urgent need for educating and instilling life style modification at every opportunity of contact with the public.
Risk factors for developing cardio vascular disease:
Women undergoing natural premature menopause younger men 35 years have 2-3 fold increase of heart attack, and those women removal of ovaries along with uterus there is 7 times increased risk of heart attack. Women need to be aware of this fact because hysterectomy is so commonly performed surgery in our country.
Estrogens before menopause protects cardiovascular health.
Premature menopause associated with an increase in blood pressure.
It becomes more important to diagnose and monitor blood pressure at menopause transition to prevent cardiovascular disease.
Modifiable risk factors for cardiovascular diseases:
Encourage an optimal blood pressure of below 120/80mm through
- Life smile modification
- Maintaining a healthy weight
- Regular exercise
- Restricting salt
- Taking a diet rich in fresh fruits and vegetables
- Low fat milk.
Cardiovascular disease is two time higher in women with diabetes as compared to women without diabetes.
Central obesity increases the risk of developing type 2 diabetes.
Metabolic syndrome is so common in post-menopausal women now a days and is characterized by
- Increased weight circumference plus
- High triglyceride
- Low HDL
- High blood pressure and high fasting blood sugars.
Women with metabolic syndrome are high risk for heart diseases and high death rate and wont prognosis.
Menopause transition has great impact on lipids
Good HDL levels decrease 2 years proceeding menopause and levels of at menopause.
At pre-menopause there is increased level of
- Total cholesterol levels
- LBC cholesterol levels by an absolute of 10% at 6 months before menopause.
Life style risk factors:
Depression is an independent predictor of heart disease and death among women with no history of heart disease previously.
Increased BMI is associated with a 37% increased incidence of cardiovascular disease.
For women with a BMI > 29 72% of their risk is related to the excess weight.
Exercise improves the various risk factors associated with cardiovascular disease by its well documented beneficial effect an
- Lipid profile
- Psychological benefits
- Low fat
- High carbohydrate diet is recommended
- High fibre
- High intake of polyunsaturated fat is supported to reduce risk of cardiovascular disease.
Role of menopause specialty in reducing heart disease risk:
Evaluation of cardiovascular risk factors from
Advice on therapeutic life style management:
- 30 minutes of moderate intensity physical activity on most 5 days a week
- Muscle strengthening activities at least 2 days a week
- Dietary advice:
- Weight reduction to BMI 18.5 to 23kg/m
- Management of stress and depression
- Sleep 7-8 hours of day.
If an optimal healthy lifestyle line above is adherent to, it would decrease
- 9% of the cases of diabetes
- 57% of cases of hypertension
- 40% cases of high cholesterol
This reinforces how important it is for young woman to adopt and maintain a healthy life style that includes
- Not smoking
- Maintaining a lower BMI
- Engaging in at least 2.5 hours of physical activity a week
- Watching no more than 7 hours per week of television and eating healthy diet.