Heart disease and heart health are essential topics for women of all ages to discuss. Heart disease often manifests differently in women than in men and can develop with silent symptoms. At True., we emphasize the importance of early prevention through screenings, lifestyle changes, and medication options. With new tests and preventive measures available, it’s crucial to start now and focus on prevention rather than reversal. This month on Let’s Chat, Dr. Bitner and Dr. Egan discuss heart disease in women and how to work towards a healthy heart.

What is heart disease?

Heart disease encompasses several conditions affecting the heart and blood vessels, including Coronary Artery Disease (CAD). CAD is a blockage caused by plaque buildup in the walls of the arteries that supply blood to the heart.

While men often experience plaque buildup in the middle of blood vessels, women tend to develop plaque more evenly throughout the walls of their arteries, making it harder to detect with standard tests. After menopause, the process of plaque buildup can accelerate, putting women at greater risk for heart disease or a cardiac event in their midlife. Regular testing and preventive action are essential for early detection and reducing heart disease risk in women.

Knowing your risk factors is the first step to preventing heart disease.  Doctors typically assess major risk factors like tobacco use and diabetes, followed by other factors such as: 

• Family history
• High cholesterol levels
• Inflammatory diseases
• Stressful life events
• High blood pressure
• Obesity 

These risk factors can influence heart disease, which can often be managed through early intervention and lifestyle changes. To minimize your risk, it is essential to identify and understand these factors. By consulting with your doctor, you can start implementing lifestyle changes, early detection testing, and further treatments, if necessary, to focus on prevention rather than reversal of heart disease. 

Early detection testing

With advancements in testing, early detection of heart issues has become more accessible and less invasive. Several options are available to assess heart function, including: 

• Electrocardiograms (ECG) record the heart’s electrical activity to detect arrhythmias, heart attacks, and other cardiac conditions.
• Stress tests assess how well your heart functions under physical stress to detect potential heart disease. 
• Echocardiograms use ultrasounds to visualize the heart’s structure and function, helping diagnose heart disease.
• Calcium Test CT scans determine the measurement of calcium deposits in the coronary arteries to assess the risk of heart disease.

Early detection and regular testing are not merely important; they can be life-saving. Given the silent nature of heart disease, beginning regular screenings early is crucial for establishing habits that reduce your risk and keep you informed about your heart health. 

Medications available

Estrogen

Estrogen plays a crucial role in preventing the development of heart disease due to its effects on insulin and sugar metabolism, kidney function, blood pressure regulation, liver and lipid metabolism, and blood vessel health. During menopause, as estrogen levels decline, blood vessel walls become stickier, and cholesterol levels increase.

By starting hormone replacement therapy early, women can reduce their risk of heart disease by slowing the development of arterial plaque and preventing massive inflammatory processes that can lead to dangerous ruptures and clots. While hormones are a safe option, it’s essential to start them before the development of heart disease and consult with your doctor about risk factors that can affect heart disease’s response to hormones.

Blood sugar medication

There are various medications available that can help manage elevated blood sugar levels. New weight loss drugs aid with weight loss and manage blood pressure while expanding to have the potential to prevent the progression of coronary heart disease.

Cholesterol medication

Optimizing cholesterol levels is an important preventive step for heart health. Cholesterol has several components, and understanding these different aspects can help us manage it effectively. Proper cholesterol medication helps lower cholesterol and is shown to help stabilize the inflammatory wall to further help prevent heart disease. 

Take-Home Tips:

• Know your phase of ovarian function
• Understand your family history related to heart disease
• Know your key health numbers (blood pressure, cholesterol, etc.)
• Familiarize yourself with available resources for heart health
• Understand hormone replacement therapy (HRT) options and considerations

Questions to Ask Your Provider:

1. What is my phase of ovarian function, and how does it impact my heart health?
2. What is my risk of early cardiac disease, given my current health status?
3. Can you explain the Coronary Artery Calcium Score CT and its relevance to me?
4. What treatment options do I have to reduce my risk of coronary artery disease?
5. What are the gender-specific recommendations I should follow to improve my heart health?

Be Empowered

You deserve the best care, and it shouldn’t depend solely on your doctor’s expertise. We want to empower you to find a doctor who truly understands your needs, whether they specialize in midlife care or heart disease. Advocate for yourself to ensure you receive accurate information and have access to all available options.

We want to empower women to take control of their health journey by getting the best medical advice and having access to solutions. Don’t brush heart disease under the rug; get in contact with a trusted medical professional and begin a conversation about your risk for heart disease. Take control of your heart health and have regular testing to learn about your risk! At True., we support you with resources, advice, solutions, and open dialogue to help you reclaim your health.

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