Heart Disease in Women: The Myths and the Truth
Additional Risk Factors
Family History
I am a healthy 50-year-old woman. I do not have high blood pressure or diabetes and my lipid profile is in the normal range. However, my father had a heart attack at age 70 and two of his brothers had heart attacks in their late sixties. Does this mean I have a family history of heart disease? Do I need to be concerned?
Family history is an important determinant of risk,
particularly premature CAD in a family member.
Premature family history of CAD means that you
have a first-degree male relative under 55 years
of age with CAD or a first-degree female relative
(mother, sister) under 65 with CAD. Age and
gender are contributory risk factors. Males have
a greater lifetime risk of developing CAD.
Menopause
Does menopause increase the risk of heart disease?
Many women seem to be protected from heart disease before menopause. As women age, their risk of heart disease rises. The loss of natural estrogen as women age may contribute to the increased risk of CAD after menopause.I’ve read so much in the news lately about hormone replacement therapy and heart disease. What are the latest recommendations?
Based on recent clinical trials showing no benefit of postmenopausal hormone therapy for cardiovascular disease prevention and possible adverse effects, the American Heart Association does not recommend postmenopausal hormone therapy for the prevention of cardiovascular disease in women with (secondary prevention) or without (primary prevention) existing CAD. Combined estrogen plus progestin hormone therapy should not be initiated or continued to prevent cardiovascular disease in postmenopausal women. Other forms of menopausal hormone therapy (e.g., unopposed estrogen) should not be initiated or continued to prevent cardiovascular disease in postmenopausal women pending the results of ongoing trials. Although hormone therapy is not recommended for cardiovascular disease prevention, women and their healthcare providers should weigh the potential risks of therapy against the potential benefits for menopausal symptom control.