Despite the national attention that heart health gets in February, and the American Heart Association’s Go Red for Women campaign, too many women are still surprised when I tell them heart disease should be on their radar.
Did you know that a woman dies approximately every minute due to heart disease? And the worst part is, so many cardiovascular conditions can be prevented, if you just have the right information.
There are a lot of myths about heart disease that reduce the sense of urgency women might feel about taking good care of their heart. In fact, according to the American Heart Association, only one in five women thinks cardiovascular disease is a major health risk for them. Many women still think that heart disease is a man’s disease, or they’re too young to be affected, or they don’t have traditional symptoms so their problem can’t be heart related. These ideas are outdated and dangerous.
Anyone can be at risk for heart disease, especially if they aren’t making conscious lifestyle decisions to protect themselves. This is especially true for women after menopause. How are menopause and heart health connected? Like with so many health conditions, it all relates to hormonal balance.
Let’s take a look at how hormones impact heart health, and then I’ll give you some natural ways to keep your hormones balanced and your heart pumping strong!
Hormones and Their Connection to Heart Health
Hormones are chemical messengers in your body, letting major organs and systems – including the heart – know what is required for optimal functioning. When hormone levels aren’t where they should be, these messages can get garbled and your health can suffer.
Some hormones that have the greatest impact on heart health include cortisol, thyroid hormones, and estrogen. Let’s take a look at how each connects to heart health.
The detrimental effects stress has on health are numerous, and the importance of reducing stress is increasingly being acknowledged by health care professionals. Research shows that high levels of cortisol, released when the body is experiencing stress, impact many common risk factors for heart disease, including increases in cholesterol, triglycerides, blood pressure and blood sugar.
On the flip side, low levels of cortisol aren’t good for the heart either. Cortisol is an anti-inflammatory hormone. Having enough cortisol to quiet inflammatory processes is important because these inflammatory responses initiate cardiovascular disease.
It’s important not to ignore emotional stressand the impact it can have on cortisol levels, as well as on heart health. We talk about stress related to work, family responsibilities, and physical trauma, but not so often about the impact that emotional trauma can have.
But there’s a lot of research, including the groundbreaking Adverse Childhood Experiences study, that indicates that “heartache” has real, physical consequences. Research has shown that higher ACE scores correlate with much higher risk of heart disease.
Your body doesn’t know the difference between physical stress and emotional stress. The physiological response – elevated stress hormones – is the same. That’s why it’s so important to be aware of both.
Did you know that thyroid hormones are actually quite important to heart function? They influence how hard and fast your heart beats, as well as both blood pressure and cholesterol levels. That means that you could end up with heart problems if your thyroid gland isn’t producing balanced amounts of hormones.
If you suffer from hypothyroidism (insufficient amounts of thyroid hormones) your heart rate slows. High cholesterol and high blood pressure are other potential results of low thyroid levels.
Hyperthyroidism (high levels of thyroid hormones) is less common, but also has an impact on the heart. It can cause high blood pressure and trigger heart palpitations or atrial fibrillation.
Age is not the sole – or even the most important – factor in women’s risk for heart disease. Still, there is an increased risk as women get older, especially when they are postmenopausal. Why is this?
Age is a factor in part because of the accumulation of the effects of poor lifestyle choices people have made over the years. A lifetime of eating foods filled with sugar and simple carbohydrates, or twenty years of smoking, can certainly mean your risk for heart disease increases. But the hormonal fluctuations that often accompany menopause also play a role.
Estrogen typically decreases in menopause. Higher levels of estrogen help keep the inside layer of artery walls strong allowing blood vessels to be flexible and improving blood flood. That means that natural drop in estrogen can stiffen the blood vessels, causing hypertension (high blood pressure) and putting additional demand on your heart.
A dip in estrogen can also change your cholesterol levels, increasing the LDL (“bad”) cholesterol and decreasing the HDL (“good”) cholesterol. Imbalanced cholesterol levels can increase risk of heart attack and death from cardiovascular disease. Declining estrogen levels can also cause heart palpitations (irregular heart beat).
Does Hormone Replacement Therapy Reduce Risk of Heart Disease in Postmenopausal Women?
There was a time when hormone replacement therapy was considered standard care for women – even if they weren’t exhibiting they usual menopausal symptoms. This came, in part, from the idea that HRT could protect your heart from disease after menopause. But the Women’s Health Initiative indicated that the risks of HRT often outweighed the benefits of HRT, and physicians stopped prescribing it as a matter of course.
A 2011 analysis of results from multiple studies showed that postmenopausal hormone therapy does not reduce the risk of coronary heart disease, and the authors concluded it should not be used as a prevention method. This analysis also showed that stroke and venous thromboembolism rate increase in women who use hormones after menopause, so screening for stroke risk factors is important.
The good news is that even though HRT may not be the best course of action for many women, there are many natural remedies and lifestyle changes that can reduce uncomfortable symptoms that occur before, during, and after menopause. However, more and more research is now coming out looking at HRT with bio- identical hormones and now the tide is again turning showing that HRT may indeed have some benefit if started at menopause for some.
Keep Your Hormones Balanced and Your Heart Healthy With These 5 Tips
My primary goal is to help women realize that so much of their health is within their control. Even when you exhibit risk factors you don’t have any control over – a family history of heart disease, or the natural process of aging – there are plenty of choices that can make to reduce that risk. The following 5 tips can help keep hormone levels balanced and your heart healthy and strong.
1. Quit Smoking
Smoking cigarettes is a major cause of cardiovascular disease. The number of cigarettes you smoke per day, and the number of years you smoke, have a direct impact on your risk of developing heart disease. If you are a smoker, the best thing you can do to protect your heart is to quit. Just one year after quitting, risk of heart attack drops significantly – even if you’ve already had a heart attack. And five years after quitting, risk of stroke drops to that of someone who has never smoked. So it’s not too late!
Smoking has also been shown to disrupt endocrine function, which suggests that quitting will help you keep your hormone levels balanced as well.
2. Stay Active
Regular activity impacts hormone levels, sleep quality, stress, and your heart. And you don’t have to put in hours at the gym — all activity counts! Aim for 2 ½ hours of moderate activity per week. Try biking or walking to work, taking the stairs whenever you can, and finding other fun ways to get out and get moving. Ballroom dancing is my favorite choice but you may prefer a kickboxing class, zumba, or a solitary run.
Eat a heart healthy diet. Good nutrition is the cornerstone of good health. Healthy diets may vary slightly depending on your specific goals, but they all share similar features. Eating plenty of fruits and vegetables will provide you with the essential nutrients you need. Whole grains, low-fat dairy products, poultry, nuts and fish are also great choices in a well balanced diet. When considering heart health, it’s best to limit red meat and avoid processed foods, along with sugar filled foods and drinks.
3. Practice Moderation
A glass of red wine can have a beneficial impact on heart health, but several will do more harm than good. Too much alcohol can raise triglycerides in your blood, lead to high blood pressure, make weight management more difficult, and lead to other serious problems. Limiting consumption to one drink per day is best.
4. Reduce Stress
Since stress can have such a large influence on hormonal balance and heart health, finding ways to relax is critical in reducing risk. Traditional relaxation techniques such as meditation, yoga, mindfulness and breathing exercises can work well to calm stress responses. Perhaps add an app from your smart phone to help with relaxation. Finding activities that bring you joy is also crucial in reducing the stress in your life. Setting aside time to have coffee with a friend, watch a favorite tv show, or take a walk on the beach is just as important as work and family responsibilities. I suggest scheduling time to relax just like you would any other appointment – and then make sure you keep those appointments@!
5. Tune in to Emotions
Holding on to negative emotions can keep stress hormones flowing, and prompt you to see out other self-soothing behaviors such as overeating, smoking, alcohol or other drugs. Confronting the trauma of your past can set you free, allowing your body to heal the physical signs of that trauma. This can be a difficult and painful process, but I promise that it’s worth it. You might need to seek professional help from a trusted therapist to help you work through these difficult feelings.
A Healthy Heart is Largely Up to You – Start Reducing Your Risk Factors Now!
When it comes to your health, you can’t afford to be complacent. There are so many easy steps you can take to strengthen your heart and balance your hormones. I’m not saying these steps are always easy, but I want you to know that you can control many of the factors that contribute to heart disease, including imbalanced hormones. You don’t have to dread getting older – I say it’s time to get better! There’s so much of life left after menopause – I want to help you enjoy every day!
Reviewed by Dr. Mark Menolascino, MD