Women Should Cut Heart Disease Risks Before Menopause 

The longer women wait, the greater the threat 

The ticking of a woman's biological clock signals the approaching end of her reproductive years. But a new study suggests it should also serve as an alarm about increasing risks for heart disease. 

The research says waiting until after menopause to take steps to reduce the risk of a heart attack or stroke is waiting too long.

"What this research tells us is that the time to begin reducing your risk of heart disease is before you actually are at risk. And for women, that means making the appropriate lifestyle and dietary changes prior to when menopause begins," says Carol Derby, study author and an assistant professor of neurology and epidemiology at the Albert Einstein College of Medicine in New York City.

The findings were presented at the American Heart Association's recent annual conference on cardiovascular disease, epidemiology, and prevention in Miami.

The research involved some 1,300 women between the ages of 42 and 52 who were evaluated for future risk of heart disease. Based on their current status, by the time they turned 55, more than half the women would need some type of lifestyle change or drug therapy to avoid a heart attack or stroke, the researchers projected.

Perimenopause Key Time To Address Heart-Related Health Issues

The take-home message, says Derby, is clear: "Women need to recognize that the perimenopausal period is the key time in which to address the issues that increase their risk of heart disease later in life—and to do so before they reach the point where their age becomes another significant risk factor."

For cardiologist Dr. Dan Fisher of New York University Medical Center, the advice is sound but can be a double-edged sword.

"While it's a good idea to reduce risk factors for heart disease before problems develop, at the same time women should not come away with the idea that they can throw caution to the wind up to age 54 and then suddenly make the appropriate changes, because that's not always going to help," he says.

Most Risk Factors For Heart Disease Have Cumulative Effect

In reality, Fisher says, most risk factors for heart disease have a cumulative effect. So the earlier you begin to adopt healthy behaviors—such as quitting smoking, losing weight, or keeping appropriate cholesterol levels—the better off you will be.

The new study was based, in part, on the National Cholesterol Education Program Adult Treatment Panel Guidelines. They are part of a system that utilizes a series of risk factors, including age, to determine at what point cholesterol levels require medical intervention to protect against heart disease. That intervention can include drug therapy or lifestyle changes, such as losing weight, or both.

According to the guidelines, the age at which intervention is usually first considered is 55, so the researchers used this year as a criterion in their study as well. Then they looked at the current heart disease risk profiles of the women in the study, who came from five different racial or ethnic groups. Those profiles included current cholesterol levels, blood pressure and amount of body fat, as well as contributing lifestyle factors such as smoking.

"If nothing else about these women would change, we used their current risk profile to project into the future and see how many would fall into the treatment category by the time they turned 55," Derby says.

The end result: The projections showed that if nothing else but age changed, 65 percent of the women would require treatment to avoid serious heart disease. Of that 65 percent, 19 percent were Hispanic; 18 percent were African-American; 15 percent, Caucasian, 8 percent, Japanese; and 5 percent, Chinese.

This information will hopefully help women realize the need to look at themselves and their health risks during the perimenopausal years, and make the changes that can affect their heart disease risk later in life, Derby says.

Fisher agrees, but also suggests that change is needed much earlier. "We need to make reducing the risk for heart disease a lifetime lifestyle, beginning as young as possible," he says.

Always consult your physician for more information.

Heart Disease Prevention

Living a healthier lifestyle can help to prevent heart disease. This includes the following:

• eliminating all tobacco products
  You should be aware that all tobacco products are included as risk factors for chronic illness, not just cigarettes. And, although there may be medical uses from derivatives of some social drugs, such as alcohol, there is no therapeutic use for nicotine. As soon as you stop smoking, your body begins to heal itself from the devastating effects of tobacco.
  

• adhering to a heart-healthy diet
  One aspect of managing your heart attack risk factors includes eating a heart-healthy diet, including appropriate levels of the following:
  

  • calories

  • cholesterol

  • fat

  • fiber

  • sodium

Refer to the government's food pyramid and food labeling laws and consult your physician or a registered dietitian for more information.

Maintaining a heart-healthy, balanced diet will help to:

• following an appropriate exercise program
  One vital step toward reducing your chances of having a heart attack is making the time to exercise. Today, with our fast-paced society, people must schedule time to exercise. Choose an activity that you enjoy doing, then talk with your physician about an exercise plan that meets your individual capabilities and needs.

An exercise program will help in the management of almost all stroke and heart attack risk factors.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)          

American Academy of Pediatrics (AAP)

American Heart Association

National Cholesterol Education Program Adult Treatment Panel Guidelines

National Heart, Lung, and Blood Institute (NHLBI) 

National Institutes of Health (NIH)

April 2003

The Longer Women Wait, the Greater the Threat

Perimenopause Key Time To Address Heart-Related Health Issues

Most Risk Factors For Heart Disease Have Cumulative Effect

Heart Disease Prevention

Heart Disease Prevention Should Actually Start In Childhood

Online Resources 

In Other News About Your Heart Health:

Heart Disease Prevention Should Actually Start In Childhood

New guidelines recommend heart healthy behavior for kids 

Armed with increasing proof that heart disease begins in childhood, the American Heart Association has issued the first set of heart disease prevention guidelines aimed specifically at children.

"Many studies have shown an association between atherosclerosis and high cholesterol, high blood pressure, and obesity beginning in children as young as 5 years old," says Dr. Rae-Ellen Kavey, chairman of cardiology at the Children's Memorial Hospital in Chicago and lead author of the guidelines.

Yet, she adds, while guidelines exist for preventive care for adults at risk for heart disease, there were no similar guidelines for children despite the knowledge that early intervention can be enormously effective in delaying the onset of disease.

"It's a process that begins in childhood, so guidelines have to begin in childhood," she says.

Kavey presented the guidelines at the American Heart Association's recent annual conference on cardiovascular disease, epidemiology, and prevention in Miami.

A year in the making, the guidelines present a comprehensive list of the health risks associated with heart disease, including overweight, high blood pressure and/or cholesterol, diabetes, and a family history of heart disease. They are followed by recommendations to pediatricians for reducing those risks.

"It's all put together in one statement to emphasize that physicians need to think of these things together. It's something to put on a bulletin board in their offices," says Dr. Stephen Daniels, a pediatrics professor at Cincinnati Children's Hospital Medical Center who also collaborated on the guidelines.

The guidelines offer a list of things physicians can do to promote cardiovascular health in all children and directives for young people already at risk for heart disease. Included as well is a large bibliography of studies for physicians who want to read the research upon which the recommendations are based.

For otherwise healthy children and teens, suggestions are to regularly assess children's heart health by checking weight, blood pressure, and lipid levels if deemed necessary. The guidelines also ask physicians to recommend healthy food choices, such as eating more fruits and vegetables, to restrict the intake of saturated fats to less than 10 percent of a child's daily caloric intake, and to keep sugar intake low.

Next, the guidelines emphasize the importance of limiting sedentary activity—no more than two hours of television and/or sitting at the computer, for instance—and being physically active every day. The dangers of smoking are also discussed. The authors hope this focus will prompt healthier behaviors when children are young.

"It's much easier to establish healthy eating and physical activity patterns than to change unhealthy patterns later," Kavey says.

The second part of the guidelines targets those children or teenagers already at high risk of cardiovascular disease. These include children with a body mass index (BMI) over the 85th percentile for age, height and weight, a blood pressure reading in the 90th percentile for age, sex, and height, and a cholesterol reading of 170 or higher. Also putting children at higher risk is family history of heart disease, particularly if male family relatives had heart disease before age 55 and female relatives before the age of 65.

Information here concerns specific monitoring of weight, diet and physical activity, blood pressure, cholesterol, and recommendations for interventions with medications.

"These guidelines are excellent tools for educating pediatric providers," says Dr. Thomas Klitzner, chief of pediatric cardiology at the Mattel Children's Hospital, University of California at Los Angeles.

"The problems, particularly of obesity, are daunting, and steps like this are essential if we are going to begin to approach a solution to this problem," he adds.

Always consult your child's physician for more information.