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July 12, 2012



At the
outset of describing the number one cause of death in aging women, we need to
understand the terminology:

Cardiovascular disease (CVD): This is
an umbrella term that includes all heart disease, hypertension, stroke, and
some diseases of the blood vessels.

Coronary heart disease (CHD): Disease
of the blood vessels feeding the heart can cause heart attacks (myocardial infarction) and heart-related
chest pain (angina pectoris).

Venous thrombo-embolism (VTE): Blood
clots forming in the leg or pelvic veins can break off and be carried to the
lungs. Here the clot blocks an oxygen-carrying artery to a part of the lung,
which is then starved of oxygen and nutrients and the segment of lung
essentially dies (infarction).

Atherosclerosis: The
accumulation of fat-like plaques in the wall of an artery, a disease called atheromatosis, can lead to
atherosclerosis, which is a diseased and narrowed artery. If an artery that
feeds the heart (coronary artery) becomes blocked, the result will be a heart
attack. In the brain this would result in a stroke.

There are
many factors that contribute to the development and progression of the above
problems. But it is now beyond doubt that the female hormones play a
significant role.  Early loss of
ovarian function results in increased risk of CVD.

Given the
rapid advances in knowledge about all of this, we are now at a point where the
most frequent cause of death and disability in older women can actually be
reduced. This is something that offers great hope.

development of CVD is complex, and certainly there are many factors that
contribute to this. The following are the key risk factors:

General Risk Factors

1.   Abnormal
blood fat levels, particularly cholesterol

2.   High
blood pressure (hypertension)

3.   Diabetes

4.   Obesity

5.   Cigarette

6.   Poor diet

7.   Physical

8.   Family
history of stroke or heart disease

Women-only Risk Factors

1.   Early
menopause, before age 45

2.   Surgical

3.   Oral
contraceptive use

4.   Low
levels of estrogen

5.   Starting
hormone therapy 10 years after menopause

complex as this may appear, these lists, and how we can approach the prevention
and treatment of many of these factors, give great cause for hope.

normally functioning ovary during the reproductive years obviously offers some
protection against the development of vascular disease and all its subsequent
negative outcomes like heart attacks and stroke.

If you
closely consider the items in the two lists above, you will realize that we
could mix and match them into two other lists that classify them in a quite
different way:

Unavoidable Risk Factors

1.   Family
history (your genes)

2.   Age of

3.   Susceptibility
to increased cholesterol

4.   Hypertension

5.   Diabetes

Potentially Alterable Risk Factors

1.   Abnormal
blood fat levels, particularly cholesterol

2.   High
blood pressure (hypertension)

3.   Diabetes

4.   Obesity

5.   Cigarette

6.   Poor diet

7.   Physical

8.   Surgical

9.   Low
levels of estrogen

Starting HT more than 10 years after menopause

Oral contraceptives

Clearly, more factors are actually within your control to reduce your risk of
heart attack, stroke, and the negative impact they may have on duration and
quality of life.

Have a
great week!


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