I Left My Heart in San Francisco

The menopausal transition is a particularly important time of life to take stock of your risk of heart disease, because risk increases as estrogen levels decrease. In fact, heart disease is the leading cause of death in American women. More than 400,000 of us will die every year from this disease, which is higher than deaths annually from cancer, Alzheimer’s, lung disease and accidents combined. I hope that statistic got your attention.

Here are 5 important things to know about heart health and wellness.

1. What are the most common heart disease risk factors?

Age over 60, physical inactivity, unhealthy diet, cigarette smoking, chronic stress, high blood pressure, depression, diabetes, abnormal cholesterol, obesity, waist circumference > 35 inches, pregnancy-related high blood pressure or diabetes and early menopause < 40 years old.

There are many factors on this list that you can do something about. I will cover weight gain at midlife in an upcoming blog called What’s the Skinny on Weight Gain?

2. Healthy lifestyle choices are the only way to go, unless you really want to go!

The American Heart Association has made it really easy for women to know the secret exercise formula that is associated with reducing the risk of heart disease. Here it is. We have to do some kind of moderate to rigorous aerobic activity for at least 30 minutes/5 days a week. It can be as simple as brisk walking, so you cannot use the “I don’t belong to a gym” excuse any longer. My own secret is to listen to my favorite disco tunes as I walk briskly on my home treadmill, which is on a slight incline, while simultaneously carrying light weights. I will send you my playlist if you need it.

3. A drink a day keeps heart disease away.

Now here comes another secret! One glass of alcohol per day is associated with a reduced risk of heart disease in midlife women. Red wine always gets the attention, but any alcohol does the trick. I prefer a Bombay Sapphire martini with a lemon twist. You might want a margarita. It really doesn’t matter. The key here is to enjoy only one glass when it comes to improving heart health. And by the way, if you do not drink at all, this is not an invitation to start. Cheers!

4. Should women take a daily low-dose aspirin?

The US Preventive Services Task Force recently issued new guidelines recommending the use of low-dose aspirin for the primary prevention of heart attacks and stroke for 50-59 year olds, if you have a 10% or greater ten-year heart disease risk and expect to live for at least ten more years. Where is that crystal ball when you really need it? My best advice here is to discuss this important issue with your primary healthcare professional. As a tease, however, the use of aspirin in this same age group can reduce the risk of colon cancer too. You will read all about that in an upcoming blog called, Hooray For Colonoscopy!

5. Does estrogen therapy prevent heart disease?

The answer may surprise you, because the pendulum has swung back and forth so many times on this question that you may have been hit in the head. Here is the bottom line. Estrogen therapy can be both helpful and harmful in the heart. When symptomatic menopausal women use estrogen to treat hot flashes and night sweats, they do indeed enjoy heart protective benefits. The secret is to start estrogen therapy close to the menopause transition. Once you are 10 years past your last menstrual period, you have missed this estrogen therapy boat.

So as I close out my blog, I would just like to tease you with the fact that my new book, Menopause Confidential: A Doctor Reveals The Secrets To Thriving Through Midlife is chock-full of everything you ever wanted to know but were too hot, tired and cranky to ask.

Are you dealing with any of these issues? I’d love to hear from you in the comments below.