Menopause doesn’t cause cardiovascular disease, but as women get older, there are diets and lifestyle adjustments that can help decrease your risk for hypertension, unhealthy cholesterol ratios, heart attack and stroke. The American Heart Association states that 1 in 3 women will be affected by heart disease after menopause and is the leading killer of women.
Estrogen and Heart Health
Before the results from the Women’s Health Initiative (WIH) became apparent, doctors routinely prescribed synthetic estrogen or hormone replacement therapy to post-menopausal women to protect them against heart disease. The thinking was that estrogen is protective and important for keeping the arteries healthy for optimal blood flow and prevention of cardiac events as women age. But 5.6 years into the randomized study, researchers found that women taking synthetic estrogen & progestins were actually at a higher risk for heart disease, stroke as well as breast cancer. In fact, after eight years, the women on combination hormone therapy were 69% more likely to develop heart disease.The study was stopped early as it was apparent that synthetic hormone therapy was not beneficial for preventing heart disease and in fact, put these women at higher risk.1
High Blood Pressure?
Common advice from your doctor decreasing sodium intake to help decrease your blood pressure – but the real problem is often that you are not taking in enough potassium – or not absorbing enough from the fruits & vegetables that you are eating. Often, diuretics will cause this imbalance which can cause a viscous cycle since many people who have high blood pressure are also taking diuretic medications.
Magnesium supplementation also will help to increase absorption of potassium for natural lowering of your blood pressure.
Stress also can cause high blood pressure – it’s important to take a good look at all the stressors in your life and address them one by one to for overall stress reduction. Both physical and mental stress can cause increase cortisol – the stress hormone- that can increase your blood pressure significantly. A daily meditation practice, whether it’s a walking meditation or 5 minutes in the morning and at night, can help the body and mind reconnect for improved stress resiliency and calmer outlook on life events.
High Cholesterol? All Fat Is Not Created Equal…
We have also been told to decrease fat in our diet when our cholesterol is high but actually, studies show that Excessive amounts of omega-6 polyunsaturated fatty acids (PUFA) and a very high omega-6/omega-3 ratio, as is found in today’s Standard American diets, are the cause of many chronic diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases. Higher omega 3 fatty acid – and lower Omega 6 fatty acid intake often helps to improve risk for heart disease. Improving your Omega 6:3 ratio to less than 4:1 (most people on a standard American diet are 10:1) improves your risk for a cardiac event by 70% over 2 years. But improving your ratio can also decrease your risk for Type 2 Diabetes by decreasing grains and high glycemic carbs for a lower HGbA1c and fasting insulin levels.2
Cholesterol is also used to make hormones like progesterone, testosterone, cortisol; estrogens- driving your cholesterol level below 150 can affect your hormone balance negatively. Cholesterol can be made from almost every cell in our bodies and is extremely important for the health of each cell.
Statin drugs are often recommended by your doctor to decrease cholesterol levels but these drugs can carry risks and are definitely worse for women. Statin drugs, as well as beta-blocker medications for high blood pressure, deplete your body of an enzyme called CoQ10 – causing muscle cramps, muscle fatigue and neuropathic pain, tingling in extremities and even mental confusion or memory problems in the elderly. This enzyme is extremely important for optimal cell functioning for the production of energy or ATP. If taking a statin or beta-blocker medication, take at least CoQ10 100mg/day for adequate replacement and energy production. Supplementing with CoQ10 also has been shown to improve arterial blood flow for decreased hypertension regardless if you are taking statins or not.
Having a high cholesterol level is not always a bad thing, unless this cholesterol is being carried around in the wrong lipoproteins (fats).
For example, having a lot of low density lipids (LDL) lipoproteins is associated with heart disease, while having a lot of high density lipids (HDL) lipoproteins is associated with reduced risk for heart disease- this is the simplified version of the story. But advanced laboratory testing can pinpoint if you are at risk for cardiac disease – looking deeper than HDL and LDL. Looking at the LDL ‘particle number’ as well as inflammatory markers like homocysteine is a more accurate risk factor that is rarely measured but an important way to look deeper into your heart health. Interesting to note that refined sugars and carbohydrates- and not fat- are what increases LDL particle number.3
Calcium Intake and Arterial Plaque
In menopause, we are often told to increase our calcium for our bone health. Sounds logical but we are now finding too much of the wrong calcium supplementation can actually increase our risk for atherosclerosis (plaque in our arteries) from calcium being deposited into the lining of our arteries – putting women at risk for heart attack. Many studies confirm the dangers of traditional calcium supplementation – especially when taken without Vitamin D3, magnesium, and Vitamin K2. Vitamin K2 assures that the calcium supplementation that is being taken into the body gets deposited into the bones – and not the arteries or kidneys. Post-menopausal women should increase their intake of green leafy vegetables and food-based, calcium (non-dairy if possible). If taking calcium supplementation, doses higher than 800mg/day should be avoided as the focus should be on calcium-rich foods for proper absorption and bone health.
Path Toward Prevention
It is easy to feel overwhelmed and not sure of what to do or what steps to take for proper heart health. Here are 5 steps you can take today to start your path toward prevention:
- Fiber: Flaxseeds are tiny seeds that contain soluble fiber, lignans, and plant-based omega-34 fats. All of these components may have an effect on the health of arteries or the level of blood cholesterol. As a bonus for women, lignans found in ground flax seeds help to eliminate estrogens from the body that can cause cancer. Increase your soluble fiber with vegetables and whole grains as well – oat bran in particular. A large 2015 review on the metabolic effect of oats on type 2 diabetes and Cholesterol levels. The study concluded that oat fiber significantly reduced fasting blood sugar, total cholesterol and LDL lipoprotein cholesterol levels. A meal consisting of oatmeal also reduced the post-meal blood sugar and insulin response making it the ultimate ‘slow carb’ for a low glycemic diet. Increase oat bran to 35-50gms/day to improve your LDL particle numbers and blood sugar.
- Supplements: magnesium, CoQ10, Vit D3, Vit K2 are all important supplements and can often be found combined in high-quality supplement brands for your heart health.
Omega-3 fish oil, avocado, or cooking with avocado oil and olive oil as well as grass-fed beef are all great sources of Omega 3 fatty acids to add to your daily diet. The elimination of vegetable oils, transfats and minimal intake of commercial red meat can help decrease your omega 6 intake to improve your 6:3 ratio.
- Pay attention to your heart energy – The Heart Math Institute (heart math.org) has numerous studies explaining the importance of connecting with your heart in meditation for stress reduction and improved stress resilience in our everyday lives. Science meets mind-body medicine! Heartmath.org
Diet & Lifestyle is more important than your genetics and your genetics are not your destiny. There is much talk about your DNA profile or maybe your family history of heart disease and stroke. It is good to know your risk but it can be overwhelming. Even if you have specific genetic polymorphisms (SNPS) that put you at risk, daily choices about your diet, exercise and stress levels may be more important for prevention or reversal of heart disease. If you have a family history of high blood pressure, heart attack or stroke, it is empowering to know what you can do to prevent heart disease to make positive changes in your family history.
Writing Group for the Women’s Health Initiative Investigators. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal WomenPrincipal Results From the Women’s Health Initiative Randomized Controlled Trial. JAMA. 2002;288(3):321–333. doi:10.1001/jama.288.3.321. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/195120
US National Library of Medicine National Institutes of Health. The importance of the ratio of omega-6/omega-3 essential fatty acids. Simopoulos AP. Biomed Pharmacother. 2002 Oct;56(8):365-79. Review. PMID: 12442909. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12442909
ScienceDirect.com. Effects of coenzyme Q10 on vascular endothelial function in humans: A meta-analysis of randomized controlled trials. October 25, 2011. https://www.sciencedirect.com/science/article/pii/S0021915011010173
Nordqvist, Christian. (2017, December 20). Can fish oils and omega-3 oils benefit our health? https://www.medicalnewstoday.com/articles/40253.php
American Heart Association. (2015, July). Menopause and Heart Disease. Retrieved from http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Menopause-and-Heart Disease _UCM_448432_Article.jsp#.Wox736inHIU
US National Library of Medicine National Institutes of Health. A low-carbohydrate/high-fat diet reduces blood pressure in spontaneously hypertensive rats without deleterious changes in insulin resistance. Am J Physiol Heart Circ Physiol. 2013 Jun 15;304(12):H1733-42. doi: 10.1152/ajpheart.00631.2012. Epub 2013 Apr 19. PMID: 23604708. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23604708
BMJ 2013;346:f228. Long term calcium intake and rates of all cause and cardiovascular mortality: community based prospective longitudinal cohort study. Retrieved from http://www.bmj.com/content/346/bmj.f228%20
BMJ 2010;341:c3691. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. Retrieved from http://www.bmj.com/content/341/bmj.c3691