When we think about heart disease, many of us still picture a middle-aged man clutching his chest. Yet cardiovascular disease is not just a man’s health issue. It is one of the leading health concerns for women too, and understanding the risks is an important part of protecting long-term health.
This World Heart Day, we’re turning the spotlight on women’s heart health – from the risk factors every woman should be aware of, to the ways menopause can influence cardiovascular risk, and the symptoms that should never be ignored. Because when it comes to heart health, knowing what to look out for can make all the difference.
Heart disease is not just a man’s disease.
Cardiovascular disease (CVD) describes a group of conditions affecting the heart and blood vessels, including coronary heart disease, heart attack and stroke.
Women can develop cardiovascular disease at any age, although the risk of coronary heart disease generally increases during and after menopause.
Despite this, heart disease has historically been perceived as something that affects men more than women. This can contribute to women underestimating their own risk and, importantly, to symptoms not always being recognised quickly.
Research and awareness campaigns have highlighted inequalities in the diagnosis and treatment of women with heart disease, including the risk of symptoms being misinterpreted or attributed to other causes.
Understanding your heart health is therefore an important part of looking after your overall health – particularly as you approach and go through menopause.
Why does cardiovascular risk increase around menopause?
Before menopause, women generally have a lower risk of coronary heart disease than men of the same age. That changes during and after menopause, when cardiovascular risk increases.
One reason is the decline in oestrogen that occurs during the menopause transition. Oestrogen has effects on the cardiovascular system, including helping to regulate cholesterol and supporting healthy blood vessels.
Menopause can also coincide with changes in other cardiovascular risk factors, including blood pressure, cholesterol, blood glucose, body composition and weight. This makes the menopause transition an important opportunity to take stock of your heart health rather than simply accepting changes as an inevitable part of getting older.
Know your individual risk factors
There isn’t one single cause of cardiovascular disease. Your overall risk is influenced by a combination of factors.
Some of the most important include:
- High blood pressure
- High cholesterol
- Diabetes
- Smoking
- Being physically inactive
- Living with overweight or obesity
- Family history of cardiovascular disease
- Increasing age
- Diet and alcohol intake
For women, there are also some additional factors that deserve attention. These can include pregnancy-related complications such as pre-eclampsia and gestational diabetes, as well as early or premature menopause.
Knowing your risk factors doesn’t mean you should worry about them. It means you have an opportunity to do something about the factors that can be changed or treated.
Additionally, here at the clinic, we provide alternate services for patients unable to use HRT to help reduce the risk of cardiovascular disease. These include specialists to advise on lifestyle changes such as maintaining a healthy diet, exercising, losing weight, quitting smoking, and introducing techniques to manage blood pressure, heart palpitations, stress, and anxiety using cognitive behavioural therapy (CBT). These services also complement and work nicely alongside HRT.
Don’t dismiss symptoms
One of the most important messages for World Heart Day is simple: don’t ignore symptoms that could be related to your heart.
Heart attack symptoms can vary from person to person. Chest pain or discomfort is a common symptom, but women may also experience symptoms such as:
- Shortness of breath
- Feeling sick or nauseous
- Sweating
- Light-headedness
- Pain or discomfort that spreads to the arm, neck, jaw, back or stomach
- A feeling of pressure, squeezing or heaviness in the chest
Some symptoms can also be mistaken for indigestion, anxiety or other conditions.
If you think you could be having a heart attack, call 999 immediately. Don’t wait to see if the symptoms go away.
Other symptoms, such as unexplained breathlessness, chest discomfort, persistent palpitations, reduced exercise tolerance or swelling around the ankles, should also be discussed with a healthcare professional.
What about heart palpitations during menopause?
Palpitations – the sensation of your heart racing, pounding, fluttering or skipping a beat are common during the menopause transition and can be associated with changing hormone levels.
However, it is important not to automatically assume that every change in your heart rhythm is “just menopause”.
If palpitations are new, persistent, worsening, associated with chest pain, breathlessness, dizziness or fainting, or are causing you concern, seek medical advice.
Your symptoms deserve to be assessed rather than dismissed.
Can HRT help protect your heart?
This is an area where the evidence has developed considerably, and the answer isn’t simply yes or no.
Hormone replacement therapy (HRT) is an effective treatment for many menopausal symptoms, and current evidence suggests that oestrogen may have a protective role against coronary heart disease, particularly when HRT is started in women under 60 or within 10 years of menopause.
However, HRT should not be prescribed solely to prevent cardiovascular disease. Whether HRT is appropriate depends on your individual circumstances, symptoms, age, timing of menopause, medical history and cardiovascular risk factors.
This is why an individualised conversation with a healthcare professional is so important.
For women with cardiovascular disease or significant cardiovascular risk factors, decisions around HRT should be made carefully and on an individual basis.
Small changes can make a big difference
The good news is that there are many things you can do to support your heart health.
You don’t need to completely overhaul your lifestyle overnight. Small, sustainable changes can make a meaningful difference.
Move your body
Regular physical activity can help manage blood pressure, cholesterol, weight and overall cardiovascular health.
Find something you enjoy – whether that’s walking, swimming, cycling, strength training, dancing or simply being more active throughout the day.
Look after your diet
A heart-healthy diet includes plenty of fruit and vegetables, wholegrains, pulses, nuts and other nutritious foods, while limiting foods high in saturated fat, salt and added sugars.
Don’t smoke
If you smoke, stopping is one of the most important things you can do for your heart and overall health.
Know your numbers
Understanding your blood pressure and cholesterol levels can give you a clearer picture of your cardiovascular risk. If you have diabetes, keeping your blood glucose under control is also important.
Know your family history
Ask your family about any history of heart disease, heart attacks or strokes. Your family history can help inform conversations about your own risk.
Look after your mental wellbeing
Stress, anxiety and poor sleep can all affect how we feel and function. Making time for rest, connection and activities that support your mental wellbeing is part of looking after your health as a whole.
Make this World Heart Day about you
Your heart doesn’t wait until you’re ‘old’ to need looking after. Whether you’re in your 30s, navigating perimenopause, postmenopausal or simply thinking more seriously about your future health, it’s never too early (or too late) to understand your cardiovascular risk.
This World Heart Day, why not make a commitment to yourself?
Know your numbers. Know your symptoms. Know your risk factors. And don’t be afraid to ask questions about your heart health.
Because looking after your heart isn’t just about adding years to your life. It’s about protecting the years you have ahead.
If you have concerns about your cardiovascular health, speak to your GP or another appropriately qualified healthcare professional. If you experience symptoms that could indicate a heart attack, call 999 immediately
If you would like to find out more about how menopause can affect your heart health, the British Heart Foundation and The British Menopause Society offers further information, practical advice and support.
Call 01252 915333 or email info@thefemalehealthclinic.co.uk if you would like to know more
