Heart Health for Women

By Amanda H. Fey, ND

Did you know that coronary heart disease is the leading cause of death in women? It is also the leading cause of disability among women, and American women are four to six times more likely to die of heart disease than breast cancer.

Coronary heart disease occurs when the arteries that supply blood to the heart become hardened and narrowed due to plaque (the accumulation of fat, cholesterol, and other substances) formation inside the vessels’ walls. As plaque builds up, the blood flow to the heart is greatly reduced. Heart disease can lead to a heart attack, which happens when an artery becomes completely blocked due to plaque.

Compared to men, many women before the age of menopause are partly protected from coronary heart disease, heart attack, and stroke. As women age, their risks of heart disease and stroke rise. The reasons for the lower incidence of coronary heart disease in younger women are not clear. One reason may be that sex hormones change the disposition of fat on men’s and women’s bodies. Male sex hormones cause a higher amount of abdominal fat (apple shaped), and female hormones cause fat to be deposited predominately on thighs and hips (pear shaped). However, overweight women with the “apple” fat distribution are at greater risk of developing heart disease even if they haven’t reached menopause. Numerous studies have indicated that abdominal obesity also increases the risk of high blood pressure and diabetes.

A second explanation may be the differences in fat composition between men and women. There are two components of cholesterol to be familiar with: high density lipoprotein (HDL) cholesterol, which is associated with a beneficial, cleansing effect in the bloodstream, and low density lipoprotein (LDL) cholesterol, which encourages fat to accumulate on the walls of arteries and can eventually clog them. As men go through puberty, their HDL levels decline causing their blood vessels to be exposed to higher levels of LDL due to a poorer ability to remove LDL from the vessel wall. This also occurs in women as they go through menopause. Postmenopausal women’s LDL cholesterol appears to increase while HDL decreases as a direct result of estrogen deficiency. This change in blood lipids in women after menopause may be one reason cardiovascular disease rates between men and women start to narrow around the age of 50.

Until recently, many postmenopausal women were prescribed hormone therapy to help prevent heart disease. Menopausal hormone therapy may include estrogen and progestin or just estrogen alone. Research now is showing that estrogen-progestin therapy is increasing the chance of developing heart disease, stroke, blood clots, and breast cancer. The use of estrogen alone has shown in research to increase the risk of blood clots and stroke, but not heart disease. Currently, the American Heart Association is not advising women to take postmenopausal hormone therapy to reduce the risk of coronary heart disease or stroke.

Symptoms of heart attack in women present differently than in men. Research by the National Institutes of Health (NIH) indicates that women often experience new or different physical symptoms as long as a month or more before experiencing heart attacks. Among the 515 women studied, the symptoms most commonly reported were unusual fatigue (70.6%), sleep disturbance (47.8%), and shortness of breath (42.1%). Surprisingly, fewer than 30% reported having chest pain or discomfort prior to their heart attacks, and 43% reported no chest pain during any phase of the attack. The NIH study, titled “Women’s Early Warning Symptoms of AMI” (AMI stands for acute myocardial infarction, in other words, heart attack) is one of the first to investigate women’s experience with heart attacks, and how this experience differs from men’s.

Heart disease is, in most cases, directly related to diet and lifestyle. This is an issue that both the conventional and alternative medicine communities agree on. Family history and genetics do play a role, but risk factors such as smoking, diet, exercise, and stress can be modified to reduce people’s risk.

In addition to addressing the effects of diet and lifestyle in prevention and treatment of heart disease, naturopathic doctors utilize natural therapies such as fiber, antioxidants, omega fatty acids, CoQ10, garlic, hawthorn berry, magnesium, and others to help women prevent and treat heart disease. There is considerable scientific data demonstrating the effectiveness of these natural therapies in lowering cholesterol, managing blood pressure, preventing clots and strokes, strengthening heart muscles, and preventing oxidative damage to vessel walls, all of which are implicated in heart disease.

Naturopathic doctors employ individualized holistic health plans in their approach to preventing and treating cardiovascular disease. A comprehensive plan that includes dietary changes, routine exercise, stress management, smoking cessation, nutritional supplementation, and herbal extracts yields outcomes that present a serious and viable option for the individual who is at high risk for or has heart disease.

Dr. Amanda Fey is a Naturopathic Doctor at the Integrative Medicine Center in downtown Ithaca, NY (www.doctorfey.com). She can be reached at 607.275.9697.


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