Coronary heart disease (CHD) is the leading single cause of disease burden and death in Australia. (1) It is largely preventable, as many of the risk factors for CHD are modifiable. These include:
- Tobacco smoking
- High blood pressure
- High cholesterol
- Insufficient physical activity
- Poor diet and nutrition
- Overweight and obesity.
Based on the Australian Bureau of Statistics 2017-2018 National Health Survey, 2.8% of the adult population had CHD. It is estimated that in 2017, 61 800 people aged 25 and over had a coronary event (either a heart attack or unstable angina) – around 169 events every day! (1)
In 2018, CHD was the leading single cause of death in Australia. (1)
(Picture from Heart Foundation: Key Statistics: Cardiovascular Disease https://www.heartfoundation.org.au/activities-finding-or-opinion/key-stats-cardiovascular-disease)
Menopause and Heart Health
CHD risk increases for everyone as they age, but for women, symptoms can become more evident after the onset of menopause. Menopause doesn’t cause cardiovascular diseases, but certain risk factors increase around the time of menopause, and a high fat diet, smoking or other unhealthy habits begun earlier in life can also take a toll. (2)
Risk factors that increase around menopause include (2):
- Age at menopause. Studies show that women who reach menopause at or before 45 years of age have an increased risk of CHD.
- Type of menopause. Women who have had surgical removal of both ovaries at an early age (less than 40-45 years old) have a higher risk of CHD. Women who have had ovaries removed at around the age of natural menopause showed no greater risk of CVD.
- Level of Oestrogen. Oestrogen, which helps to keep blood vessels relaxed and open, starts to decline in perimenopause. As this happens, cholesterol may build up on artery walls, which may lead to atherosclerosis or stroke.
- Hot flushes and night sweats. Hot flushes have bene linked to high cholesterol, insulin resistance and high blood pressure.
- Sleep disturbance. Poor sleep is associated with greater risk of metabolic syndrome*.
- The SWAN Heart Study and the WHI (women’s Health Initiative) found that depression was significantly associated with CHD.
*Metabolic syndrome is diagnosed when a person has three or more of these individual risk factors: abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure and high blood sugar.
What can you do to reduce the risk?
- Eat a healthy diet. There are many benefits to a healthy diet, not just for heart health. Eat a wide variety of foods, with plenty of vegetables. A low-saturated fat, high-fibre, high pant food diet can substantially reduce the risk of developing heart disease (4).
- Keep active. There is a strong association between increased activity and reduced risk of CHD (2). Current Australian recommendations for adults aged 18-64 years are to do either:
- 5 to 5 hours of moderate intensity physical activity – such as a brisk walk, golf, mowing the lawn or swimming
- 25 to 2.5 hours of vigorous intensity physical activity – such as jogging, aerobics, fast cycling, soccer or netball
- An equivalent combination of both moderate and vigorous activities (5).
- Maintain a healthy body weight. The more overweight you are, the harder your heart has to work to give your body nutrients. Being obese increases the risk of developing heart disease (6).
- Reduce stress. Studies show that long term stress can increase cholesterol, blood sugar and blood pressure. Stress can also affect how the blood clots, increasing risk of stroke. Acute stress can trigger heart problems like poor blood flow to the heart muscle (7).
- Be aware of underlying health conditions. Health conditions such as diabetes, high blood pressure and high cholesterol increase the risk for coronary events such as heart attacks or angina attacks. Ensure to manage these conditions under the guidance of your healthcare practitioner.
- Avoid smoking. Smokers have twice the risk of heart attack than non-smokers. Second-hand smoke also increases the risk of heart disease (8).
(Picture from Heart Foundation: Key Statistics: Cardiovascular Disease https://www.heartfoundation.org.au/activities-finding-or-opinion/key-stats-cardiovascular-disease)
Conclusion
Heart disease is the highest cause of death and health burden in Australia. Risk of heart disease can increase after menopause, but there are ways to reduce your risk. Talk to your doctor or book an appointment with one of our naturopaths or nutritionists to discuss how you can reduce your risk.
References
- AIHW, 2020, Coronary Heart Disease, viewed 3 February 2022, https://www.aihw.gov.au/reports/australias-health/coronary-heart-disease
- El Khoudary SR et al, 2020, ‘Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement from the American Heart Association’, Circulation 142:e506-e532,viewed 3 February 2022, https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000912
- Price Lundberg G & Kass Wagner N, 2019, ‘Menopause Hormone Therapy: What a Cardiologist Needs to Know’, American College of Cardiology, viewed on 8 February 2022, https://www.acc.org/latest-in-cardiology/articles/2019/07/17/11/56/menopause-hormone-therapy
- Victoria State Government, 2021, ‘Diet and Heart Disease Risk’, viewed on 8 February 2022, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/heart-disease-and-food
- Australian Government, 2021, ‘Physical Activity and exercise guidelines for all Australians: For Adults (18 to 64 years)’, viewed 8 February 2022, https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years
- Carbone S et al, 2019, ‘Obesity paradox in cardiovascular disease: where do we stand?’, Vascular Health and Risk Management, 15:89-100, viewed on 8 February 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503652/
- Dimsdale J 2009, ‘Psychosocial Stress and Cardiovascular Disease’, Journal of the American College of Cardiology, 51(13):1237-1246, viewed on 8 February 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633295/
- Begum J, 2021, ‘Menopause and Heart Disease’, WebMD, viewed on 8 February 2022, https://www.webmd.com/menopause/guide/menopause-heart-disease
About The Author - Hayley Derwent
Hayley is a holistic nutritionist whose vision is to inspire and educate patients about food and lifestyle to positively enhance their health and wellbeing. She provides a safe and caring environment by listening, teaching and supporting people and working in partnership with them to strive towards good health and happiness.