By Dr. Nissi Suppogu, Guest columnist
Heart disease remains the leading cause of death among women, yet many are unaware that their cardiovascular risk begins to rise significantly between ages 50 and 55. Natural changes associated with aging, including the hormonal shifts that occur during and after menopause, can increase a woman’s risk of heart disease. The good news is that up to 80% of heart disease is preventable. Identifying risk factors early and making even small, consistent lifestyle changes can have a meaningful impact on heart health, longevity and quality of life.
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Why heart disease risk increases after menopause
For women, menopause marks an important turning point in cardiovascular health and is confirmed after one year of no menstrual period. The decreasing estrogen levels cause various physiological changes that, in turn, affect cardiac health. Some of the cardiac effects of menopause are:
- Cholesterol: Higher LDL (“bad”) cholesterol levels and inactive HDL (“good”) cholesterol levels.
- Blood vessels: Increased arterial stiffness and thickening of blood vessel walls, which can contribute to high blood pressure.
- Weight: Increased abdominal fat and fat accumulation around internal organs.
- Sleep: Changes in sleep patterns that can negatively affect heart health.
In addition to these physiological changes, many women have other risk factors that can further increase their risk of cardiovascular disease. These include premature menopause before age 40 and pregnancy-related complications such as gestational diabetes, preeclampsia, high blood pressure during pregnancy and preterm delivery. Certain cancer treatments, including chemotherapy and radiation, can also affect cardiovascular health during treatment or even years later.
Women are also more likely to experience certain conditions associated with increased cardiovascular risk, including rheumatoid arthritis, lupus, depression, obesity, chronic stress and anxiety.
Heart disease symptoms can look different in women
One reason heart disease is often missed in women is that symptoms do not always match the classic image of crushing chest pain. Women frequently experience more subtle symptoms that can be mistaken for other conditions.
Symptoms women should never ignore include:
- Chest discomfort, pressure or tightness, pounding sensation.
- Shortness of breath.
- Pain in the neck, jaw, shoulder, back or upper abdomen.
- Dizziness or lightheadedness.
- Unusual fatigue.
- Nausea or indigestion-like symptoms.
If chest discomfort or other symptoms are sudden, severe or accompanied by shortness of breath, sweating, nausea, weakness or lightheadedness, call 911 immediately. Do not drive yourself or wait for the symptoms to pass. For symptoms that are mild, persistent, recurring or less urgent, it is important to speak with your primary care provider and request a referral for further evaluation.
Know your numbers
One of the most effective ways to prevent heart disease is understanding your personal risk factors.
All women should have annual health checkups and know your numbers for:
- Blood pressure.
- Cholesterol levels.
- Blood sugar levels.
- Body mass index.
- Waist circumference.
The earlier risk factors are identified through regular screening, the more opportunities there are to prevent future heart problems and maintain an active, healthy lifestyle.
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Healthy habits that protect your heart
Up to 80% of heart disease is preventable, and it starts with a healthy lifestyle.
Regular physical activity, heart-healthy eating, quality sleep and stress management all play important roles in cardiovascular health. Aim for at least 150 minutes of moderate exercise each week, and focus on fruits, vegetables, whole grains, lean proteins and healthy fats while limiting processed foods, sodium and added sugars. Women should also aim for seven to eight hours of sleep each night and find healthy ways to manage stress.
The importance of personalized care for women
Women do not always experience cardiovascular disease in the same way as men. While many people are aware that heart disease symptoms can look different in women, certain cardiovascular conditions are also more common in women and may require specialized evaluation. Conditions such as microvascular disease, coronary vasospasm, spontaneous coronary artery disease, stress induced cardiomyopathy and other forms of heart disease may not present with significant artery blockages.
Because of these differences, heart-related symptoms and underlying conditions are difficult to identify using traditional testing alone. If symptoms persist despite previous normal cardiac testing, women should discuss whether additional evaluation or a second opinion from a specialist in women’s heart health may be appropriate.
It’s never too late to start
Lifestyle changes can still make a difference after years of unhealthy habits. Research consistently shows that improving diet, increasing physical activity, controlling blood pressure, managing cholesterol, maintaining healthy weight and quitting smoking can significantly reduce cardiovascular risk, regardless of age.
Heart disease is not an inevitable part of aging. By taking steps to understand personal risk factors, staying current with preventive screenings and making small, sustainable lifestyle changes, women can protect their heart health and continue enjoying healthy lives with their loved ones.
Dr. Nissi Suppogu is the medical director of the Women’s Heart Center at MemorialCare Long Beach Medical Center’s Heart & Vascular Institute. She is a cardiologist with a passion for improving women’s heart health conditions that are present throughout an adult female’s lifespan. She focuses on preventing heart conditions at every stage and is specially committed to the accurate and timely diagnosis of female-specific presentations of heart diseases.
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