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Declining Estrogen: Role in Heart Disease

Heart attacks strike Asian men and women at younger ages and the attacks are more deadly compared to any other ethnic group. Almost one in three in this group will die from heart disease before age 65. In India, cardiovascular disease remains the No. 1 cause of death. One study found that South Asians developed heart disease 10 years earlier than other groups.

Factors that have been observed to be the root cause are unhealthy diet pattern (typical South Asian diet tends to be high in sugar, refined grains, and fatty foods.), lack of exercise, smoking, being overweight, metabolic syndrome and hormone levels etc.

Role of Menopause

Natural estrogen is protective for the heart prior to menopause, therefore women tend to get heart attacks 10 to 15 years later than men. After menopause, with declining estrogen levels,a woman’s risk for heart disease not only approaches but surpasses that of a man with similar risk factors once a women is greater than 75 years of age.

You may have gone through early menopause, either naturally or because you had your ovaries removed. If so, you’re twice as likely to develop CHD as women of the same age who aren’t yet menopausal.

Another reason why women are at increased risk for CHD after age 55 is that middle age is when you tend to develop other CHD risk factors, primarily due to  a poor lipid profile with higher LDL (bad) cholesterol, more harmful dense and smaller LDL particles, lower HDL (good) cholesterol, and higher triglycerides. Some also have low levels of a very important type of good cholesterol called HDL2b, with nearly two thirds of them deficient.

Women who have gone through menopause also are at increased risk for broken heart syndrome.

If you are considering estrogen supplementation for post-menopausal symptoms such as hot flashes, speak to your doctor about the risks versus benefits of estrogen supplementation

What Can You Do?

Taking action to control your risk factors can help prevent or delay coronary heart disease (CHD). Your risk for CHD increases with the number of CHD risk factors you have.

  1. Adopt a heart healthy lifestyle. A heart healthy lifestyle should be part of a lifelong approach to healthy living.
  2. Try to quit. Smoking can raise your risk for CHD and heart attack and worsen other CHD risk factors. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke.
  3. Follow a healthy diet also is an important part of a healthy lifestyle. A healthy diet includes a variety of vegetables and fruits. It also includes whole grains, fat-free or low-fat dairy products, and protein foods, such as lean meats, poultry without skin, seafood, processed soy products, nuts, seeds, beans, and peas. A healthy diet is low in sodium (salt), added sugars, solid fats, and refined grains. Solid fats are saturated fat and trans fatty acids. Refined grains come from processing whole grains, which results in a loss of nutrients (such as dietary fiber).
  4. Lose Extra Weight: If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control CHD risk factors.
  5. Be physically active. Physical activity can improve your fitness level and your health. Talk with your doctor about what types of activity are safe for you.
  6. Know your family history of CHD. If you or someone in your family has CHD, be sure to tell your doctor.

If lifestyle changes aren’t enough, you also may need medicines to control your CHD risk factors. Take all of your medicines as prescribed.

Menopausal hormone therapy will depend on:

If you experience classic menopausal symptoms, including intolerable hot flashes, vaginal dryness or insomnia, talk to your doctor about how you can relieve troublesome symptoms without putting your health at risk.

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