The following is an excerpt from my upcoming Mojo4Menopause Course:
I think most of us are aware by now that coronary heart disease (CAD), the most common type of heart disease, is the leading cause of death in both men and women and that woman are just as likely as men to get it. A lesser known fact is that women can have different risk factors and experience different symptoms of and even different types of heart disease than men. It’s important to be aware of these differences so that we can all begin to take steps to prevent CAD by lowering our risk factors, as well as, recognize possible signs and symptoms and get early treatment if needed. Prevention is always the best plan.
In menopause, heart health becomes increasingly important. As early as our forties, as peri-menopause sets in, we start to lose the protective effect of estrogen and our heart disease risk increases. Our risk factor continues to increase as our estrogen levels continue to decline in menopause and post-menopause. Our diets and lifestyles make all the difference in how we will fare.
These are the cardiovascular changes that take place starting in our forties:
- Your heart can become stiff
- Your arteries can become thick
- Your heartbeat can become irregular
- Your heart can get larger
- Your heart rate may slow down
- Your blood pressure may increase
Basically what is happening is that we are becoming more inflamed as we age and that inflammation is affecting our heart health. Researchers have long recognized chronic inflammation as a huge contributing factor to atherosclerosis (the build up of cholesterol-rich plaque inside arteries), the root cause of most heart attacks. So, just like most other chronic health issues, inflammation is the culprit, and we all have varying degrees of it. It’s been said that once we hit menopause, most of us are all basically walking around on simmer – and some of us are literally on fire from the inside out – sort of like a continuous internal hot flash!!! Let’s take a look at why we are becoming so inflamed and how we can put the fire out so to speak.
Dietary and lifestyle factors that cause inflammation:
- Making poor food choices by eating pro-inflammatory foods such as the following: nutrient-depleted refined carbs (sugar and foods that quickly turn to sugar – white flour products, white rice, sugary breakfast cereals and bakery products), highly-processed foods filled with chemicals (cold cuts, hot dogs, sausage, bacon, highly-processed plant-based foods, most packaged foods), high-fat and poor quality meats, damaged fats (trans fats, fried foods, refined vegetable oils), junk food, excess sodium, excess alcohol, excessive allergy-producing foods like gluten and dairy.
- Being overweight or obese (weight gain causes inflammation and inflammation, in turn, causes more weight gain – it’s a vicious cycle)
- Poor gut health (inflammation travels)
- Poor dental health (gingivitis, periodontitis)
- Not getting enough exercise (sitting for 10 hours or more a day has been linked to increased risk of heart attack or stroke even if otherwise active)
- Poor sleep
- Environmental toxins
- Aging in general
Our diets are of pivotal importance now because what we eat can either decrease inflammation and slow the aging of our most important, hardest working muscle or increase inflammation and accelerate it. Let’s take a look at anti-inflammatory foods that you can plug into your Hormone-Balancing Maintenance Plan, if you haven’t already, to optimize your heart health.
Foods to keep your ticker in top working order. Plug these into your Hormone-Balancing Maintenance Plan and optimize your heart health:
- Wild Omega-3 Fatty Fish: (salmon, sardines, mackerel, herring, trout, halibut, haddock, tuna). Recommendation: Eat 1 serving 2-3 times per week.
- Antioxidant-Rich Vibrantly-Colored Veggies: (green veggies such as green leafy, brussels sprouts, asparagus, celery, broccoli, bokchoy; red veggies such as peppers, tomatoes, beets; orange veggies such as yams/sweet potatoes, pumpkin, winter squash, orange peppers, carrots). Recommendation: Eat at least 1-2 servings from each group daily.
- Antioxidant-Rich Vibrantly-Colored Fruits: (red fruits such as strawberries, raspberries, cranberries, pomegranate seeds, apples; orange fruits such as oranges, cantaloupe, papaya; purple/blue fruits such as grapes, plums, blueberries). Recommendation: Eat 1 serving from each group daily.
- Healthy Fats: (heart-healthy nuts such as almonds, walnuts, pistachios; heart-healthy seeds such as flax seeds, chia seeds, pumpkin seeds). Recommendation: 1-ounce serving of nuts and 2 Tablespoons of seeds daily.
- Complex Carbs: (high-fiber legumes such as peas, beans and lentils; whole grains like steel-cut oats, quinoa). Recommendations: 1-2 1/2 cup servings daily.
- Dark Chocolate: The higher the cocoa count the better. Aim for 70% or more. Recommendation: No more than 1 ounce daily.
- Red Wine: Chock full of heart-healthy resveratrol. If you consume alcohol, this is the heart-healthiest choice. Limit to 1 4-ounce glass/day. You can also take resveratrol in supplemental form.
- Green Tea: Rich in fat-burning, heart-healthy polyphenols. Recommendation: 3 cups per day.
HOW WOMEN DIFFER WHEN IT COMES TO HEART DISEASE:
As I mentioned above, women can have different risk factors and experience different symptoms of and even different types of heart disease than men. It’s so important to be aware of these differences so that we can take measures to prevent and to treat if need be.
The first step in preventing CAD is knowing your risk factors:
The following risk factors are specific for women:
- Gestational anemia (anemia while pregnant)
- Premature menopause (before age 40)
- Past pregnancy-related problems (gestational diabetes and preeclampsia)
- PCOS (polycystic ovary syndrome)
- Using hormonal birth control
- Prior breast cancer treatment
The following risk factors are seen more commonly in women than men:
- Autoimmune disorders
- Not enough physical activity
- Being overweight or obese
- Metabolic syndrome: (high blood pressure, high bad cholesterol (LDL) and low good cholesterol (HDL), high blood sugar). You are more likely to have Metabolic Syndrome if you had gestational diabetes, have a family history of diabetes (type 2), nonalcoholic liver disease (fatty liver – ie deep visceral belly fat), polycystic ovary syndrome or sleep apnea.
Step 2 in preventing CAD is being aware of the symptoms that are specific to women:
Research suggests that women may or may not experience the following symptoms for several weeks before a heart attack:
Chest pain (tightness, pressure, squeezing, aching): This is the most common symptom among both men and women but women can also experience a heart attack without having any chest pain at all. In post-menopause it is common for this symptom to be severe.
Exhaustion: Extreme and unusual fatigue is common in the weeks leading up to, as well as, just before a heart attack occurs.
Weakness (often accompanied by anxiety, dizziness, fainting, feeling lightheaded): Feeling unusually weak and/or shaky is a common acute symptom of a heart attack in women.
Shortness of breath (or heavy breathing): Experiencing these breathing issues without exertion, especially when accompanied by fatigue or chest pain is often a warning sign of a heart attack.
Excessive Sweating: Breaking out in a sweat without due cause, or feeling suddenly cold and clammy are common heart attack symptoms in women. This is especially common in post-menopause.
Upper body pain (upper back or either arm, neck, jaw, abdomen): This pain can either start in one area and gradually spread to others, or it may come on suddenly. This is especially common in post-menopause.
Sleep disturbances (difficulty getting to sleep, unusual waking during the night, feeling tired despite getting enough sleep): Sleep problems in the weeks leading up to a heart attack are commonly reported by women.
Stomach problems (indigestion, nausea, vomiting): It is common for women to feel pain or pressure in the abdomen before a heart attack or experience some or all of the above digestive issues.
Rapid or irregular heartbeat: This symptom of a heart attach is especially common in post-menopausal women.
HEART DISEASE THAT IS SPECIFIC FOR WOMEN:
Two types of CAD that are specific for women are coronary microvascular disease and broken heart syndrome. Both of these are harder for doctors to spot, which means it could take longer to get a diagnosis and treatment.
Coronary Microvascular Disease (MVD): Coronary MVD is heart disease that affects the walls and inner lining of tiny coronary artery blood vessels that branch off from the larger coronary arteries. Coronary MVD is more frequently seen in women, particularly younger women. The risk factors are the same as for CAD, with the addition of the following:
- Lower than normal estrogen levels before menopause can raise younger women’s risk for coronary MVD and can be caused by stress and ovarian dysfunction.
- High blood pressure before menopause (especially systolic blood pressure).
- Severe menopausal symptoms
- Anemia (because it slows the growth of cells needed to repair damaged blood vessels).
Signs and symptoms (occur more often during routine daily activities and times of stress and less often during physical activity or exertion like in CAD) include the following:
- Angina (chest pain – often prolonged, even at rest)
- Nausea and vomiting
- Shortness of breath
- Belly pain
- Trouble sleeping
- Lack of energy
Diagnoses of: Standard diagnostic tests for CAD (Coronary angiography, Stress test, Coronary magnetic resonance (CMR) imaging) may not be able to detect coronary MVD as these tests look for blockages in the large coronary arteries not the tiny coronary arteries.
Recommended testing includes:
- Cardiac catheterization with coronary flow reserve (CFR) is the gold standard for diagnosing coronary MVD but is very invasive.
- Positron emission tomography (PET scan) represents the most validated imaging exam for the non-invasive identification of coronary MVD.
Broken Heart Syndrome: Medically known as takotsubo cardiomyopathy or stress-induced cardiomyopathy is triggered by stress or loss. The condition was first recognized in 1990 in Japan where it was named takotsubo because when it is present, the left ventricle of the heart changes shape, developing a narrow neck and a round bottom, resembling an octopus pot called takotsubo used by fisherman in Japan.
The condition is on the rise, especially among middle-age and older women (ages 50 to 74 being the most rapidly increasing group).
Signs and symptoms include the following:
- Chest pain
- Shortness of breath
Diagnoses of: If broken heart syndrome is suspected, the following tests may to done to confirm the diagnoses:
- Electrocardiogram (ECG or EKG) measures the electrical activity of the heart. ECG results for broken heart syndrome look different than those for a heart attack. Coronary angiogram uses X-ray imaging to see the hearts blood vessels. People with broken heart syndrome often don’t have blockages in the blood vessels, while people who’ve had a heart attack usually do.
- Echocardiogram is a non-invasive test that uses sound waves to create images of the heart’s size, structure and motion. Broken heart syndrome is easy to detect with this method of testing because of it’s telI-tale shape the left ventricle takes on (resembling an octopus pot).
- Cardiac magnetic resonance imaging (Cardiac MRI) uses a magnetic field and radio waves to create detailed images of the structures of the heart.
- Blood tests to look at cardiac enzymes which are usually higher in people that have broken heart syndrome.
Broken Heart Syndrome is rarely fatal and has a better prognoses than a regular heart attack. There is no standard treatment and most people recover within about a month. There is about a 10 to 15 percent possible chance of reoccurrence. It can reoccur more that once and the trigger can be different each time.
When it comes to your heart health, I cannot stress enough the importance of getting the proper blood work and diagnostic testing if necessary. Honestly, this can be a matter of life and death. It is unfortunately not uncommon these days to hear that someone, who just got a clean bill of health on their yearly physical, suffered a heart attack shortly after. Getting the proper preventative testing can make all the difference. Just as important is having it accurately analyzed with preventative ranges in mind. Standard lab ranges are way to wide which puts most people in the normal range when they are not.
It is so important to do advanced testing beyond mere total cholesterol, HDL, LDL and triglyceride levels as they don’t tell the whole story. In addition to your routine blood work, speak to your doctor about adding the following heart health markers to your lab requisition:
- C-reactive protein (CRP) – researchers at the Center for Cardiovascular Disease Prevention discovered that people with higher levels of C-reactive protein, a measure of inflammation in the blood, were at increased risk of having a heart attack or stroke in the future. Recommended Supplements if your number is above a 2: Omega-3’s, an an inflammatory complex which includes a combination of herbs, nutrients and proteolytic enzymes for modulating the inflammatory response. My Choice: OmegaAvail TG1000 Dose: 1 softgel 2x per day with a meal, Inflammatone Dose: 2 capsule 2x/day between meals.
- Homocysteine – an amino acid in our blood, high levels of which are linked to artery damage leading to the development of atherosclerosis. Recommended Supplements if your number is above a 10: Methylated Vitamin B12, Folic acid and B6 are needed to break it down and remove it from our blood. My Choice: Homocysteine Supreme Dose: 1 capsule 2x per day with a meal
- NMR (fractionated lipid profile – a more accurate assessment of heart disease risk)
- ***Lp(a) – is an often overlooked independent genetic risk factor for heart disease. Linked to heart disease in younger adults and otherwise healthy people with no other known cardiovascular risks. Statins do not help to lower Lp(a). The gene has to be targeted – this is currently being researched. Recommended Supplements if elevated (over 20 mg/dl): time released niacin, carnitine and annatto tocotrienols. My Choices: Niacin CRT 500 mg NE Dose: 1 tablet per day with a meal, Carnitine Synergy Dose: 1 capsule per day before a meal, Annatto-E 150 Dose: 1 softgel per day after a meal
- Fibrinogen – is a blood protein produced in the liver that is important for blood clotting. If elevated, a person’s risk for CVD and stroke may increase. Recommended supplements if number is over 400: Omega 3’s and a proteolytic enzyme My Choice: OmegaAvail TG1000 Dose: 1 softgel 2x per day with a meal, Natto-Serrazime Dose: 1 capsule per day between meals
Preventative Diagnostic Testing:
- The Electron beam computed tomography (EBCT) heart scan is an excellent, non-invasive assessment tool used to detect the level of coronary artery calcification.
- The Carotid Intima-Media Thickness Test (CIMT) is used for the non-invasive assessment of atherosclerosis (the build up of plaque in and on the artery walls.
GOOD MORNING METABOLIC ELIXIR
Makes 1 serving
For amazing “Youthful Aging” benefits, drink every morning before or after breakfast. Helps to reduce cholesterol, normalize blood pressure and balance blood sugar
6 ounces pure, filtered water
1 t organic fenugreek seeds
1 t organic cumin seeds
1 t organic coriander seeds
Combine all ingredients in a glass jar with a tight-fitting lid and let soak overnight. In the morning, strain out water and drink.
Makes 1 serving
Chock full of heart-nourishing nutrients!
1/2 cup pomegranate juice (contains polyphenols (micronutrients that naturally occur in plants) that protect LDLs and HDLs from oxidation)
1/2 cup pure water
1/2 cup mixed berries (fresh or frozen) (contain polyphenols – mostly anthocyanins and fiber – shown to decrease risk of CVD)
1 tbsp flax oil
1 tbsp chia seeds
1 scoop high-quality, unsweetened protein powder
1/3 cup oatmeal
1 large fistful leafy greens
1/2 c ice
OPTIONAL: Add 1 tbsp of dark cocoa powder (70% or higher) for more heart-healthy benefits.
Put all ingredients in blender and process until smooth. For extra heart-healthy benefits, make sure to throw in a handful of leafy greens.