Heart health for women and girls: New guidelines for doctors and patients – NBC 5 Dallas-Fort Worth

Heart disease is the leading cause of death among women in the United States and around the world – a threat that is expected to increase significantly over the next two decades.

In an effort to get ahead of the risk, four major medical organizations – the American Heart Association, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics and the Society for Maternal-Fetal Medicine – have released a coordinated framework for women’s heart health from puberty to menopause.

The groups released the “Stages of the Female Lifestyle” framework on Monday, detailing how female-specific biological changes – periods, pregnancy, perimenopause and menopause – affect the heart health of girls and women throughout their lives. The guidelines provide age-specific recommendations to prevent, detect and manage cardiovascular health in women.

“Heart disease and other forms of cardiovascular disease do not suddenly become relevant when we become older women,” said Dr. Stacey E. Rosen, a former volunteer president of the AHA, who helped author the trio of scientific articles on the subject.

Women’s health care is also often fragmented across different specialties throughout a woman’s life, “contributing to suboptimal care among girls and women,” the guide’s authors write. Rosen said the new guidelines represent “a paradigm shift in how we think about women’s cardiovascular and brain health.”

“Women receive health care across different clinical specialties, but it is often fragmented or disconnected,” said Dr. Sadiya S. Khan, chair of the Scientific Advisory Group for Women’s Health at the AHA, who co-authored the guide. “Specifically, these reports connect the dots for clinicians, for patients, and across all areas of health so that care is holistic and begins as early as adolescence, recognizing that women’s heart health is uniquely shaped by biological transitions not experienced by men.”

According to the American Heart Association, cardiovascular disease, which includes heart disease and stroke, is the leading cause of death among women, killing more than 400,000 people each year in the United States. That’s more than deaths from breast cancer, lung cancer and chronic lung disease combined. Yet only 4 in 10 women (41%) recognize it as their biggest health threat.

Earlier this year, the Heart Association predicted that the percentage of women with at least one type of cardiovascular disease would increase by more than a third, from 10.7% in 2020 to 14.4% in 2050, and that nearly 60% of women in the United States would have high blood pressure by 2050.

“These projections underscore the urgency of making cardiovascular health a priority at every stage of a woman’s life,” Khan said. “This new approach gives clinicians of all specialties shared advice to recognize risks earlier, personalize prevention and act before a heart attack, stroke or heart failure. »

California Live’s Jessica Vilchis spoke with nurse practitioner Barbara Dehn, known as “Nurse Barb,” who shares tips to help you put your heart first. February is National Heart Health Month, a time dedicated to raising awareness of cardiovascular disease, a leading cause of death among women. While a focus on heart health is crucial throughout the year, this month provides a valuable opportunity to pause, reflect, and take proactive steps to protect our hearts.

Female household health stages

The “life stages” in the guidelines focus on how hormonal health affects cardiovascular health throughout a woman’s life.

For years, scientists ignored the importance of hormones in women’s heart health because monthly fluctuations made research more complicated. But estrogen, estradiol and progesterone “impact cells in the blood vessels, brain and heart muscle,” Rosen said. They affect cholesterol levels, blood cell viscosity, inflammation, blood pressure and the body’s response to stress.

“If you understand that these hormones not only affect the uterus, ovaries and fallopian tubes, but they rhythmically affect every part of the cardiovascular system and the brain, you will understand why these fluctuations or problems with these hormones in women have a huge impact” on heart and brain health, she added.

Step 1: Perimenarche (8-15 years old)

This stage represents the transition around the first menstrual period.

New publications recognize that menstrual cycle patterns can offer insight into future heart health. Persistent, heavy or irregular menstrual bleeding may serve as an early marker of cardiovascular risk, such as polyendocrine ovarian metabolic syndrome (PMS, formerly known as polycystic ovary syndrome or PCOS).

Having your first period before age 10 is linked to a higher risk of heart disease later in life. “It’s not automatically a reason to be alarmed or take medication,” said Dr. Amanda M. Perak, associate professor of pediatrics and preventive medicine at Northwestern. “This is a reason to pay a little more attention to healthy habits and routine checkups.”

By knowing their menstrual history, older adolescents may be prepared to speak with their adult doctor or health care professional after leaving a pediatrician’s care. Starting around age 12, eating disorders, which can affect future cardiovascular health, also become more common in girls, Perak said.

“The goal is not to worry teens about the risk of heart attacks, which could be decades away for almost all,” Perak said. “It is during adolescence that habits are established and it is much easier to maintain good heart health than to regain it.”

Stage 2: Ovarian cycle and pregnancy (15-44 years old)

Regular ovulatory and hormonal cycles are established at this stage, and this is also the time when pregnancy usually occurs.

Irregular or heavy bleeding can be an early sign of conditions that increase the risk of heart disease, such as PMS.

Pregnancy is often considered a “stress test” for the heart and can reveal important clues about heart health. Conditions like high blood pressure during pregnancy, called preeclampsia, or gestational diabetes aren’t just temporary: They can signal a higher risk of heart disease later in life.

Perinatal depression and anxiety, which affect up to 20% of pregnant women, can increase the risk of cardiovascular complications. Pregnancy also puts extra stress on your body, which can increase your risk of heart disease after delivery.

This fall, pediatricians affiliated with Boston Children’s Hospital are launching a new questionnaire for children, focused on family history and symptoms, aimed at identifying potential heart risk.

Step 3: Perimenopause (45-51 years old)

Perimenopause is a transition stage before menopause. Hormonal fluctuations make menstrual cycles unpredictable, varying in length or skipping a few months.

“Typically, as these changes occur, women may experience an increase in their low-density lipoprotein (“bad cholesterol”) levels, weight gain and a potential increase in blood pressure,” said Dr. Natalie A. Cameron, an internal medicine specialist and assistant professor at Northwestern.

During this time, a woman’s estrogen levels begin to drop, which can also increase certain risk factors for heart disease. This is because estrogen helps keep blood vessels relaxed and open. With less estrogen, cholesterol can begin to build up in artery walls, which can increase the risk of heart disease or stroke, as well as stiffening blood vessels and arteries.

“We don’t want to give the impression that it’s catastrophic, but recognize that there are certain changes in these phases that can influence cardiovascular risk,” Khan said.

Hormonal changes during this time can also cause mood changes and make it more difficult to get a good night’s sleep, both factors that influence cardiovascular health, Khan said.

“Hormones can influence your cholesterol levels, your blood sugar levels and your body weight. That’s not to say that everyone needs to take hormone therapy to combat this, but we need to assess these things so we can address these traditional risk factors for cardiovascular disease,” she said.

Stage 4: Postmenopause (51 years and over)

Women enter this stage after experiencing a full 12 months without a period, usually around age 51. The loss of protective estrogen puts them at increased risk of heart problems.

This is particularly important for women who went through menopause before age 45, who have a significantly higher risk of coronary heart disease resulting from plaque buildup in the arteries.

Hot flashes and night sweats are the most common symptoms associated with menopause and can last up to 10 years. They are also associated with higher levels of risk factors for cardiovascular disease.

Every stage of a woman’s life provides “windows of opportunity” to prevent heart disease, said Dr. Esther Kim, director of the Center for Women’s Cardiovascular Health at Atrium Health in North Carolina and author of one of the publications.

“We can go back to adolescence and even childhood and understand, ‘This person is at risk; we need to monitor them more closely,'” said Kim, who is also professor and chair of cardiovascular medicine at Wake Forest University School of Medicine in Charlotte.

For women themselves, it comes down to one simple point: by being proactive, they have the opportunity to reduce their risks.