How Diet, Vitamins & Hormone Therapy Effects Your Heart

Before 1991, very little research was done on health issues relating specifically to women’s health. This was especially true regarding heart health as cardiovascular problems were often considered more of an issue for older men. However, serious conditions like coronary heart disease, cancer, and osteoporosis are some of the most leading medical problems affecting death rates and quality of life in postmenopausal women in the United States.

Fortunately, in the 1990s, a massive study was launched to research specific treatments for postmenopausal women and their risks for cardiovascular disease and other serious medical problems. But while this study made massive gains in understanding postmenopausal women’s health, it is not widely known outside of the medical community.

Women’s Health Initiative Landmark Study

Three decades ago, the Women’s Health Initiative (WHI) was launched. The WHI is a long-term national health study aimed at finding strategies for preventing heart disease, breast and colorectal cancer, and hip fractures in postmenopausal women. In this article from Zepick Cardiology, you will learn how such common treatments as taking hormone supplements and vitamins changed from what this study found.

This study yielded important information that changed how postmenopausal women have been cared for over recent decades.

The study resulted in such landmark trial findings, that it even continues to this day! The main study ran from 1993 – 2005. But extensions of the study are in process to last through 2027, and possibly beyond.

161,000+ Postmenopausal Women Studied

The depths of this study go beyond how long it has run. The number of postmenopausal women studied is quite staggering. Since the launch of WHI, more than 161,000 post-menopausal women have been included in the study.

To put that in perspective. There are approximately 30,000 women of postmenopausal age here in Wichita. If every single postmenopausal woman in the city of Wichita participated, that would not even amount to one-fifth of the number of total participants in the WHI study!

This massive WHI research can be broken down into three separate studies looking into three specific types of treatments that were common for postmenopausal women: hormone therapy, dietary modification, and supplements.

Hormone Therapy & Heart Disease

The most significant findings from the research were on hormone therapies. The part of this WHI study focused on whether hormone therapy can decrease the risk for heart disease among postmenopausal women. Participants were either given estrogen alone or were taking both estrogen plus progesterone.

The WHI found that hormone replacement therapy did not prevent heart disease in postmenopausal women as once thought.

In fact, using hormone therapies can increase a woman’s risk for a variety of problems including:

• Increased risk of stroke & blood clots
• Increase risk of breast cancer
• Increased risk of heart attack and stroke

This chart shows effects the difference between women in their 70s who took both estrogen and progestin versus those who took the placebo. You can see there is a clear increase in instances of heart disease, breast cancer, and strokes for women taking hormone therapy. Similar, yet less dramatic increases, were seen among the participants who were in their 50s and 60s.

These findings caused researchers to prematurely stop this part of the study in 2002. While taking hormones were found to decrease a postmenopausal woman’s risk for hip fractures, the increased health risks for such serious issues as cardiovascular issues and cancer outweighed whatever benefits that were possible.

The WHI trial changed the scientific community’s understanding of hormone therapy benefits for postmenopausal women. These results were a major reason why there was a sudden and sustained decline in prescribing hormone therapy treatment in the United States starting in 2003.

Dietary Modification Benefits

Many postmenopausal women in the group were studied to determine if dietary modifications could improve their heart health and decrease their risk for breast cancer and colorectal cancer. Participants undertook a low-fat diet that was high in fruit, vegetables, and grains.

While eating better has many great benefits, this study did not find a significant reduction in the risk of coronary heart disease, cardiovascular disease, or stroke in these participants.

Calcium & Vitamin D Supplements

One other part of the WHI study examined the effects of calcium and Vitamin D supplements. In particular, they were trying to see if postmenopausal women who took these supplements would have a decreased risk for heart disease, colorectal cancer, and hip fractures.

The study found no sufficient change in risk for heart disease and cancer from taking vitamins.

Better Care for Postmenopausal Women

Thanks to this WHI landmark study, we have improved cardiovascular care for women who are postmenopausal. This study is one factor that has helped to greatly reduce instances of heart disease in women over the decades.

As this graph shows, the number of women 45-64 dying from heart disease or stroke has decreased since 1980.

Prior to this study, estrogen therapy had been recognized for decades as an effective treatment for many of the menopausal symptoms women experience. It was also believed to reduce the risk of cardiovascular disease. In fact, estrogen became one of the most widely prescribed medications in the world by the 1980s and early 1990s.

According to the study published in the Journal of the American College of Cardiology, “The findings shocked the medical and lay communities, leading to a seismic shift in clinical practice and a 70%-80% reduction in HT (hormone therapy) prescriptions.”

Another long-running study focusing on cardiovascular care is the Framingham Heart Study which began back in 1948. You can learn more about that groundbreaking research and how it changed heart health care in dramatic ways in this article on the Framingham Heart Study. You can also learn more about the cardiovascular risks unique to women in this article on The #1 Cause of Death for Women.

For questions about your heart health and to understand your risk for cardiovascular disease, contact the friendly team of Cardiologists and medical staff at Zepick Cardiology in Wichita, Kansas.

Understanding Cardiovascular Disease Risks for Women

It’s a sobering statistic. One in three women die from some form of cardiovascular disease.

It is the leading cause of death for women. In addition, it is also a rather common disease for women to be living with. Nearly half of all women over the age of 20 have some form of cardiovascular disease.

But how cardiovascular disease impacts women is different in many ways.  This has become a focus for a lot of new research. The factors that cause a person to be at risk for cardiovascular diseases aren’t always the same for men and women. And sometimes when the factors are the same for both sexes, the risk factors are worse for women.

Science is uncovering new information that is helpful in both the prevention and treatment of heart disease for women.

A New Focus on Women’s Heart Health

Over the past few years, new studies have begun focusing specifically on cardiovascular problems for women. A large summary of recommendations for prevention of cardiovascular disease in women was put out just this year by the Journal of the American College of Cardiology.  

All this research is great news to women, especially those facing a higher risk for developing heart issues. Instead of a one-size-fits-all treatment, these new efforts to understand how cardiovascular disease is different for women have led to improved guidelines customized for the most optimum and successful treatment specific to the needs of women.

Cardiovascular Risk Factors Unique to Women

Why do women get heart disease? Obesity, poor access to health care, and underlying health conditions are all risk factors that affect both men and women. But studies have found there are specific risk factors that put women particularly at a higher risk for cardiovascular problems.

PREMATURE MENOPAUSE

A woman is considered to have premature menopause when she experiences menopause before the age of 40. The body’s response to a drop in estrogen (including such things as changes to the distribution of body fat, glucose tolerance and higher blood pressure) causes in increased risk for cardiovascular disease. The recent research on this has been extensive, involving more than 300,000 women in testing. Early menopause (ages 40 – 44) and relatively early menopause (ages 45 – 49) were also studied and found to increase cardiovascular disease risk, although not as high.

However, there is still much we do not know about the link between early menopause and cardiovascular issues. It may be that there are other factors at play here. It could be that women who have certain factors that increase their chances for having both cardiovascular disease and early menopause.

POLYCYSTIC OVARY SYNDROME

Women of reproductive age can develop the hormonal disorder called polycystic ovary syndrome (PCOS). Women who suffer with PCOS may have infrequent menstrual periods or prolonged ones. The problems are often more severe if the woman is obese. Having polycystic ovary syndrome puts you at a higher risk of developing both heart disease as well as type 2 diabetes.

HYPERTENSION

While hypertension is a problem that can occur in both men and women, there are differences among the genders. Hypertension is less common in pre-menopausal women than of men of similar age. However, after menopause, women are more likely to suffer from hypertension then men of their age group.

Studies show there are various factors unique to women who have it. It is common for women with hypertension to:

• Be obese
• Decrease physical activity
• Increase salt intake
• Develop diabetes
• Increase alcohol consumption (more than moderate use)

These activities or factors are also some of the biggest risks that cause women to develop heart disease. Women in this situation are recommended to reduce their salt intake (ideally less than 1500 mg daily) and to increase their daily amount of potassium from foods (ideally to at least 3500 mg daily).

DIABETES

Having diabetes increases a person’s risk for heart disease, making them twice as likely to have a stroke or heart attack. Like hypertension, diabetes affects both men and women. But there are differences between the sexes in this disease and how it affects each gender’s risk for cardiovascular disease.

Girls are more likely to develop Type 2 diabetes than boys. Because of this, women tend to live longer with this disease than men. Studies show that people diagnosed with Type 2 diabetes before the age of 40 are at higher risk of dying from a cardiovascular disease.

While recent studies bring to life information that some may find troubling, it also creates the opportunity to find treatment that is most affective. Studies on gender differences regarding diabetes has resulted in revelations about certain medications working better for men with other medications working better for women.

HIGH CHOLESTEROL

The first noticeable difference between men and women who have high cholesterol is in regard to medications. Women are less likely to be given statin therapy than men for their high cholesterol. Statin therapy has been shown to reduce occurrence of cardiovascular disease. However, a lack of proper studies in the past involving women cast doubt on whether statins were a safe and effective treatment for women.

RAPID OR IRREGULAR HEARTBEAT

Atrial fibrillation is a condition where you have a rapid or irregular heartbeat. Women with atrial fibrillation are 20% to 30% greater at risk of having a stroke than men with this disease.

DEPRESSION

Having depression, emotional stress, or other form of psychological issue has been shown to increase your risk for developing cardiovascular problems. These issues been proven to be risk factors for heart attack and cardiac death. It’s been shown that women diagnosed with clinical depression face twice the risk for developing cardiovascular disease.

Depression affects about 7% of the popular each year, and it’s twice as more common for women than

men. Psychological issues are often tied to childhood instances of adversity such as child abuse or neglect. Women have a higher exposure to these adversities. Such early life adversities are known risk factors for cardiovascular disease, but even more of a predictor for women.

PTSD

Post-Traumatic Stress Disorder has been found to increase a person’s risk for heart disease. This is true of either gender but is worth noting as an increased risk factor for women since they experience this problem more than men. PTSD affects 9.7% of women and 3.6% of men.

The problem relating PTSD to cardiovascular disease is increase when you consider lifestyle factors. Those who have suffered childhood trauma are more likely to take part in unhealthy activities and choices. Whether it’s smoking, over-eating or excessively drinking, people with PTSD are often exacerbating their heart risk with such poor health behaviors.

PREGNANCY & CARDIOVASCULAR DISEASE RISK

There are many issues related to pregnancy and childbirth that put women at a much greater risk for developing cardiovascular disease. From gestational diabetes to low birth weight to pre-eclampsia, the many different types of health problems a woman can face during pregnancy leads to a high risk.

In fact, the various factors related to pregnancy are so many that we put that information out in its own article to go in depth into this article on Pregnancy & Cardiovascular Risks.

What can women do to protect your heart?

For women, this may feel like only a lot of bad news. But in reality, the new information that focuses on women’s health will help lead the way to improved treatment and care and preventative help.

1. Understand that heart disease is indeed a serious risk for all women.
2. Be proactive in getting medical care and seeking necessary treatment.
3. Stop poor health behaviors such as smoking, too much drinking and salt intake.
4. Start/increase good health activities such as incorporating physical activity in your daily lifestyle.
5. Take your mental health needs seriously.

Knowledge is power. Knowing how you are uniquely affected by heart disease or the factors that put you at greater risk creates great opportunity for you to take proper steps to help your heart health.

Heart Disease Problem in Kansas

Do we have a bigger problem with cardiovascular disease here in Kansas than they do in other states? Not really. Kansas ranks right about in the middle among most statistics on heart disease.

As you see in this graph from America’s Health Rankings, 3.6% of all Kansas females and 5.3% of all Kansas males have diagnosed heart disease. This is just a little more than the national average.

If you have any questions or concerns about your heart health or proper treatment and care, feel free to call us at Zepick Cardiology here in Wichita, KS at (316) 616-2020.

Women’s Health: Unique Risks for Developing Cardiovascular Disease

Cardiovascular disease is the leading cause of death for women in the United States. It is an important health concern that women should be aware of. While heart disease does affects both men and women, there are many different factors that can put a woman at an increased risk.

Among the risk factors that are unique to women is pregnancy. A variety of complications and health issues have been found to make a woman’s chances of facing heart issues double, triple or even worse. Here at Zepick Cardiology, we treat people of all demographics dealing with their own unique issues relating to their heart health.

New medical studies over the past few years have placed a focus on health matters that specifically affect women. There are many issues that put women at increased risk for heart disease from menopause to hypertension. A variety of complications and health issues surrounding pregnancy and birth have been found to make a woman’s chances of facing heart issues double, triple or even more.

Pregnancy: Increased Cardiovascular Disease Risks

ADVERSE PREGNANCY OUTCOMES

About 10% to 20% of all pregnancies have what is referred to as adverse pregnancy outcomes. This includes such situations as preterm birth, stillbirth, and low birth weight. These adverse outcomes have been found to be associated with an increased risk for those women to develop cardiovascular disease in their future. If you had one of these pregnancies, you are more likely to develop heart disease.

PREECLAMPSIA

Preeclampsia is a relatively rare hypertension disorder. It happens typically after 20 weeks into pregnancy and causes the woman to have dangerously high blood pressure. It can lead to serious, even fatal, problems such as seizures. Usually the condition goes away with, or shortly after, childbirth.

The most serious risks usually end when the condition ends with childbirth. But research shows that women who have experienced preeclampsia during pregnancy also face an increased risk of developing heart disease. Studies show that after 10-15 years after having preeclampsia, these women are face the following increase risks:

• 3.7 times greater risk for hypertension (high blood pressure)
• 2.2 times greater risk for ischemic heart disease (heart not receiving enough blood)
• 1.8 times greater risk for stroke
• 1.5 times greater risk for overall mortality

There are other hypertension disorders a woman can experience during pregnancy. Women who are diagnosed with any hypertensive disorder of pregnancy are at an increased risk for chronic hypertension, even as soon as within the first year after pregnancy. They also have double the risk of being hospitalized for a cardiovascular issue within 3 years of delivery.

Having a hypertension disorder during a pregnancy also increases the risk for coronary disease and for having heart failure and valvular heart disease.

GESTATIONAL DIABETES

Women who develop diabetes during their pregnancy find themselves at risk for further conditions. Not only are they at higher risk of developing type 2 diabetes later in life, they also face increased risks for heart disease. Women who have gestational diabetes have:

• double the risk of developing hypertension
• double the risk for having a stroke
• nearly three times more likely for having ischemic heart disease.

PREMATURE BIRTH

Giving birth several weeks early increase a woman’s risk for heart issues. Giving birth to a child before 37 weeks into the pregnancy doubles the mother’s risk for cardiovascular disease. It also doubles the risk for dying from coronary heart disease. When the birth happens prior to 34 weeks along, that risk is even high.

PREGNANCY LOSS

Women who have had a miscarriage or a stillbirth face greater cardiovascular disease risk. They have double the risk for having a heart attack (technically called myocardial infarction), a stroke (cerebral infarction), or renovascular hypertension.

Having had a miscarriage also puts you at 1.5 times increased risk of developing some form of cardiovascular disease. Multiple miscarriages increase that risk to 2 times.

Why it’s Important to Know Your Risks

If you faced one or more of these situations during a pregnancy, it can be disheartening to find out that it has put you at greater risk for developing cardiovascular disease. But there is some good news. With new research and knowledge into what puts women uniquely at risk for heart disease, doctors and cardiologists can be more able to react to the care you need. For example, the American College of Obstetrics and Gynecology now recommends that women who have an adverse pregnancy outcome undergo a cardiovascular risk screening withing 3 months after that pregnancy.

Getting correctly diagnosed with heart disease can mean the important treatment you need can begin sooner. In addition, when a physician identifies that a patient is at greater risk for developing cardiovascular issues, they can provide the proper recommendations to help protect the patient’s heart health. Increasing certain activities and making lifestyle changes can go far in helping a person avoid or delay developing dangerous conditions.

For some time in our medical history, women were being underdiagnosed with cardiovascular disease and/or not getting the sufficient treatment or care for it. Knowing how women are uniquely affected by heart disease or the factors that put them at greater risk creates great opportunity to help women better deal with or even prevent suffering with cardiovascular disease.

Questions About Your Heart Treatment?

When you get care at Zepick Cardiology in Wichita, we take the time to talk through your health and your risk factors. Whether you are a man or a woman, we will make sure to address your specific situation and as well as go over the best treatment and care for you.

If you have any questions or concerns regarding your heart health, feel free to call us at Zepick Cardiology at (316) 616-2020.