Coronary heart disease (CHD) is the leading cause of death for women in developed countries. For both men and women, CHD risk increases with age. It is known that the CHD risk is much lower for women than for men of comparable age. Women’s risk, however, increases significantly and “catches up” with their male counterparts after menopause. This is because estrogen, the female sex hormone, has a protective effect on women’s hearts. Unfortunately, the level of estrogen drops significantly after menopause. This makes postmenopausal women more prone to develop CHD.
Postmenopausal women are conventionally prescribed to Hormone Replacement Therapy (HRT) that contains estrogen for treatment of symptoms such as hot flushes and helps to prevent osteoporosis.
Until recently, it was thought that HRT protects women’s hearts against CHD in much the same way as the natural female hormone does before the onset of menopause. HRT works mainly by improving cholesterol levels in postmenopausal women. As we know, high cholesterol is in turn a major risk factor for CHD. Some studies in the past have shown that women who take HRT have lower rate of developing heart attacks.
A study conducted by HERS (Heart and Estrogen Replacement Study) in United States reported that women with heart disease who received HRT has no beneficial compared to women who received placebo therapy. HRT may also be harmful to these women in the first year of use. Furthermore, research also showed women who are treated with HRT may subject to serious risks such as stroke, blood clots or hypertension, various types of cancer and disease, etc.
Therefore, in the light of these recent findings, the role of HRT in prevention of heart attacks remains unproven. Postmenopausal women cannot rely on HRT to reduce the risk of CHD. HRT should in fact be avoided in women who already have CHD.
Women can protect themselves against heart disease by addressing modified risk factors. These include smoking, high cholesterol level, high blood pressure, diabetes mellitus, obesity, and a lack of exercise. It is consented among experts that cessation of cigarette smoking, participation in regular exercise and adherence to a healthy diet will be a practical and effective way in protecting women’s hearts.
If you are interested to know more about how to prevent heart disease for women after menopause, do watch out for Part II of this article in which 7 recommended tips by senior consultant cardiologist will be illustrated.
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