Cardiovascular Health After Menopause


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We know that about one out of every eight or nine women will get breast cancer over the course of a lifetime, while about one out of every two or three gets heart disease. Still, many women fear breast cancer more than heart disease. Since you’re here with us now, you’ve probably had a very good reason to be concerned about breast cancer! But you also need to pay some attention to keeping your heart and blood vessels healthy over the coming years and decades.

Certain treatments for breast cancer can increase heart disease risk by directly damaging the heart. These include some chemotherapy medications and Herceptin (chemical name: trastuzumab), as well as radiation therapy to the chest. For more information, see our page on Heart Problems in the Treatment Side Effects section.

Menopause also brings with it an increased risk of cardiovascular disease — whether that menopause is a natural result of aging or an earlier-than-expected menopause caused by breast cancer treatments. Cardiovascular disease is an umbrella term for any problems affecting the heart and blood vessels, such as:

  • high blood pressure
  • arteriosclerosis, or buildup of plaque inside the arteries
  • coronary artery disease, or buildup of plaque inside the arteries that feed the heart
  • heart attack, or blockage of an artery or arteries that supply the heart
  • stroke, or blockage of an artery or arteries that feed blood to the brain

Researchers believe that the female hormone estrogen probably plays a role in protecting the heart and blood vessels while women are younger. That’s why men’s rates of heart and blood vessel disease tend to be higher than women’s in their 30s and 40s — but women catch up later in life. Researchers aren’t yet sure exactly what estrogen’s role is, but there is evidence that it raises HDL or “good” cholesterol levels. HDL works as a kind of “mop” that picks up excess cholesterol from the blood vessel walls and sends it to the liver, which then works to remove it from the body. Once estrogen levels fall after menopause, that protection appears to go away. (So far, though, it doesn’t appear that replacing estrogen with hormone replacement therapy helps reduce cardiovascular risk.)

Besides menopause, other risk factors have a major effect on cardiovascular disease: high cholesterol, diabetes, and a family history of heart disease. Lifestyle choices such as smoking, lack of exercise, and your diet also are important factors. These habits can be hard to change, but menopause is the perfect reason to do something about them. Now is the time.

The best way to keep your heart and blood vessels healthy is through lifestyle changes. You can work with your doctor to get help with these:

  • If you smoke, get help to quit.
  • Exercise regularly.
  • Learn relaxation techniques such as meditation, deep breathing, or yoga, to name a few.
  • Eat a diet that is high in fruit, vegetables, and fiber, and low in saturated fats, sodium, and cholesterol.
  • Lose weight if you need to and make sure your Body Mass Index (BMI) is in the healthy range.

All of these lifestyle changes can help with blood pressure, cholesterol levels, and your sense of well-being. Work with your doctor to make sure your blood pressure and cholesterol are being checked regularly. These results, along with any other risk factors you have for cardiovascular disease, will be used to determine whether you need medications in addition to lifestyle changes. Taking a baby aspirin every day — if your doctor recommends it — may also be beneficial for your blood vessels.

The important thing is to form a partnership with your doctor around cardiovascular health that will last for the rest of your life. The American Heart Association web site is a great starting point.

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