Heart Disease in Women Increases After Menopause
In premenopausal women, estrogen is cardioprotective. It prevents plaque buildup in arteries, reduces inflammation and promotes vascular health. During menopause, estrogen levels decrease, increasing a woman’s risk of heart disease.
Throughout menopause, women are also more likely to have increased blood pressure, see weight changes, and experience an increase in cholesterol, specifically the bad cholesterol, LDL.
Even changes in weight and visceral fat, the fat distribution in the mid-section, can put women at greater risk for heart disease.
“During menopause or even perimenopause, women may have worrisome symptoms like palpitations and chest pain. And it can be difficult to know if they are menopausal symptoms or related to something cardiovascular,” said Mozow Zuidema, MD with Missouri Heart Center and Boone Health. “Staying hypervigilant to what their symptoms might actually be is very important.”
If you experience tightness in your chest, it should spark some sort of inquiry about what that symptom could be from. Was it anxiety, GERD, an esophageal spasm? If the symptoms come after exerting energy, but there are no other symptoms present, then getting an appropriate evaluation may be needed, whether it’s at the emergency room or a screening, depending on the severity of the symptoms.
“We are now realizing that everyone, men and women, can have either very typical symptoms – such as that feeling of an elephant sitting on the chest, or heaviness – AND atypical symptoms such as headache, shortness of breath, dizziness, nausea, vomiting, weakness and unusual fatigue, jaw, back or abdominal pain,” Dr. Zuidema said.
Typical heart attack symptoms are what used to be attributed to men’s heart disease. For women, they may attribute pressure on their chest to something else, like indigestion, and may not realize that they have heart disease.
“As women, we tend to discount what our symptoms are and keep pushing through with the list of things we need to get done that day. But we really need to realize that heart disease is the number one cause of death in women, as it is in men,” Dr. Zuidema said.
Treatment for preventing heart disease is the same at any age. Managing these will help reduce the risk of cardiovascular disease:
- Eat a heart healthy diet
- Exercise regularly
- Maintain a healthy weight
- Eliminate tobacco use
- Keep an eye on blood pressure and treat it appropriately
- Check your cholesterol
- Know blood sugar numbers and whether you may be prediabetic or diabetic
- Get regular visits with your provider
- Know your family history
If you have new symptoms or findings that needs a cardiologist input, get a referral to a cardiologist to do that screening or to further evaluate those symptoms
If a woman does have a family history of premature coronary artery disease, and all of her other risk factors are negative, then a coronary calcium score is a great screening tool.
“Women do a great job of taking care of everyone else and sometimes leave themselves last. But, in this instance, and especially during women’s heart month, we should put ourselves first,” Dr. Zuidema said.
Early Detection with the Cardiac Calcium Score
A cardiac calcium score screening checks for calcium build up (plaque) in the walls of the coronary arteries.
People with a higher calcium score are at greater risk for heart disease, heart attack and stroke.
The result will include your coronary calcium score, which is a number that can range from 0 to more than 400. A score over 100 means you are more likely to have heart disease, and a higher score means a higher risk of having a heart attack.
This is a non-invasive CT scan. Results from this scan may allow your doctor to identify possible heart disease before you have signs and symptoms.
- To make an appointment for your cardiac calcium screening at Boone Hospital or at Nifong Radiology, visit your patient portal or call Boone Health at 573-815-8150. There is a $100 out-of-pocket cost for this screening.
By Erin Wegner
To learn more about heart and vascular care, visit boone.health/heart-and-vascular-care