heart disease

Wednesday Bubble: Testosterone and the metabolic syndrome

Posted by on Nov 12, 2008 in heart disease | 4 comments

Today’s Bubble features a pretty interesting research finding: contrary to what experts have previously believed about the relationship between estrogen and the metabolic syndome evidence continues to accrue that testosterone may ultimately be identified as the culprit. I wrote about this in an earlier post and there are some interesting stats about risk, etc. (You may recall that metabolic syndrome describes the cluster of heart disease risk factors that include overweight, high blood pressure and blood sugar levels, high blood fats levels and low HDL-cholesterol.)

In the current study, published in the early online edition of the Menopause Journal, researchers evaluated 257 cases of metabolic syndrome found in a group of 1862 women enrolled in the Study of Women’s Health Across the Nation.

They found that the ratio of testosterone to estrogen during the menopausal transition, rather than changes in each individual hormone, was an important factor in determining which who would develop the metabolic syndrome. What’s more, faster increases in this ratio over time also increased risk.

What this brings to mind is the question of whether or not it is wise to use testosterone to improve sexual dysfunction during menopause? I’m going to be addressing this in a future post.

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Wednesday Bubble: Hormone therapy

Posted by on Nov 5, 2008 in heart disease | 0 comments

I was perusing the medical news last night and I came across this headline:

Hormone therapy for menopausal women not necessarily beneficial

The report feature results from the Study of Women’s Health Across the Nation, which I have referenced several times over the past six months.  This current study, which was published in the Archives of Internal Medicine was undertaken to evaluate the accuracy of the “Timing Hypothesis,” which suggests that hormone therapy should be started with 6 years of menopause to fully realize its heart protective benefits.

Researchers compared hormone and cardiovascular profiles in 782 women who were:

  1. Premenopausal
  2. Using estrogen only
  3. Using estrogen plus progesterone (hormone therapy)
  4. Posemneopausal for at least 5 years and hadn’t used hormone therapy.

The results showed that women using hormone therapy, while having more favourable ratios of high density to low density lipoproteins (i.e. good to bad cholesterol), also had higher levels of blood fats (triglycerides) than premenopausal or postmenopausal women not using estrogen alone or no hormones. These findings, according to the researchers, were associated with less favourable oxidative environment (meaning more free radicals and a higher risk of diseases like atherosclerosis).

The conclusion? That despite extending hormone therapy, there is evidence of adverse effects even among women who are free of atherosclerosis.

The bottom line is that hormone therapy, while effective for adressing menopausal symptoms, may not be the cure-all for protection against disease, as it was once touted to be.

Another bubble burst about hormone therapy.

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Poison Heart

Posted by on Oct 3, 2008 in heart disease | 0 comments

Think that menopause and declining estrogen is poisoning your heart?

Italian Researchers say “nay” to this long-standing myth, and report that aging, not menopause, is the cause of increased risk of heart disease in women after menopause.

In a new study published in the Journal of Hypertension, researchers evaluated a number of heart disease risk factors in 9,364 adults who were followed for almost 19 years. At the start of the study, these factors, which included blood pressure, body mass index, cholesterol, blood sugar, blood fats and organ damage were found to be simillar between menopausal women and men, but different between post- and pre-menopausal women.  However, when they made adjustments for age, this difference disappeared.

In other words, the difference in heart disease risk between pre- and postmenopausal women with similar risk factor profiles only existed when age, and not estrogen status, was accounted for.

Additionally, over the long-term, postmenopausal women had greater rates of high blood pressure and illness and death from heart disease compared to their pre-menopausal peers.

This may explain why estrogen has not been shown to prevent heart disease.

Now we just need to find ways to prevent heart disease in older women. Here’s a good start!

Of course, regular exercise and heart-healthy diet wouldn’t hurt either!

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Seeds of the Change

Posted by on Sep 27, 2008 in heart disease, hot flash | 0 comments

Flaxseed evidently has the potential to reduce the frequency and potential of hot flashes associated with menopause.

Last Summer, researchers from the Mayo Clinic in Rochester, MN reported results of a small trial enrolling 29 postmenopausal women who were experiencing at least 14 hot flashes weekly for a month. None of the study participants were taking estrogen or herbal preparations for their symptoms, but for six weeks, ingested 40 grams (~2.8 tbs) daily of crushed flaxseed.

Not only did the frequency of hot flashes decline by 50%, but overall severity of hot flashes decreased by 57%. Study participants also reported improvements in their mood, joint or muscle pain, chills and sweating, all of which significantly improved their quality of life.

The researchers concluded that flaxseed is potentially an effective treatment for hot flashes and imparts overall health and psychological benefits.

The downside? 50% of women experienced mild or moderate bloating and 29%, mild diarrhea.

Flaxseed is a plant-based estrogen source (photoestrogen)  that contains antioxidants with weak estrogen properties (lignans) and omega-3 fatty acids. It is also an excellent source of fiber. Various studies have not only touted its benefits for heart disease prevention but also suggest that it might boost the effects of conventional breast cancer therapies.

Most health experts recommend ground flaxseed over whole because it is more easily digestible in this form. It should be taken with ample amounts of water to avoid any gastrointestinal blockage. Flaxseed can also inhibit the ability of the blood to clot after injury so if you’re taking any heart medications or planning surgery, you might want to speak to your doctor before trying it. Additionally, it may exacerbate the effects of herbs that interfere with clotting such as:

  • Danshen
  • Devil’s Claw
  • Eeuthero
  • Garlic
  • Ginger (in large amounts)
  • Ginkgo
  • Horse Chestnut
  • Panax Ginseng
  • Papain
  • Red Clover
  • Saw Palmetto

Personally, I don’t care for the taste of flaxseed.  However, it can be baked or added to other foods. In fact, some of these recipes look pretty tasty.

Do you take flaxseed? How has it helped your menopausal symptoms? Any recipes you’d like to share?

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Like a Heatwave, Burning in My Heart

Posted by on Sep 15, 2008 in heart disease, hot flash | 5 comments

[youtube=http://www.youtube.com/watch?v=Mc7P65KNwVY]

It appears that hot flashes affect more than quality of life.

Researchers from the University of Pittsburgh report that hot flashes might actually damage the blood vessesls and increase the risk for atherosclerosis, a form of heart disease characterized by hardening of the arteries.

Study partciipants included 492 women, ages 45 to 58 years, who were participating in the community-based Study of Women’s Health Across the Nation.

The findings, which were published in the eary online edition of the journal Circulation, show a significant increase in calcium deposits and buildup  (i.e. calcification) in the greater coronary artery and aorta in women with hot flashes. In fact, these women were 1.5 times likely to develop calcification than women not experiencing hot flashes.

The researchers report that hot flashes may indicate underlying adverse vascular changes in women.

So what can you do? Because hot flashes may be signs of subclinical or underlying changes in blood vessels that can lead to heart disease, shutting them down is not enough.

Rather, lifestyle changes that promote heart health, such as a healthy diet, regular exercise, weight maintenance or reduction, quitting smoking and moderate alcohol use, seem like smart choices.

In fact, research confirms that lifestyle interventions that include healthy eating and regular exercise can confer protection against and slow different forms of heart disease, including atherosclerosis, if started during perimenipause.

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Ch Ch Changes

Posted by on Sep 1, 2008 in heart disease | 2 comments

Among the many changes that occur during menopause, one of the most potentially dangerous is actually being attributed to testosterone rather than estrogen.

Results of a 9-year study study published in the July 28th issue of the Archives of Internal Medicine show that the key hormonal change associated with developing the metabolic syndrome is the steep and progressive domination of testosterone. What’s more, this increase occurs independently of aging and other potential confounding factor (such as smoking, body mass index, ethnicity, marital status and education).

(Metabolic syndrome is a term used to describe the cluster of risk factors (e.g. abdominal fat, high blood pressure and cholesterol levels and insulin resistance) that increases the risk of developing heart disease and diabetes. It affects up to a third of women after age 55.)

Study participants included 949 women recruited from the ongoing  Study of Women’s Health Across the Nation, which is examining factors that affect health and quality of life in women during their middle years.  Women were either premenopausal or in early menopause, and had never used HRT.  Overall, women were shown to have a 1.45 times greater risk of developing the metabolic syndrome in perimenopause and a 1.25 greater risk after menopause.

So, let’s do the math.

  1. Metabolic syndrome is closely associated with high blood pressure, obesity, and insulin resistance.
  2. Menopausal women are at increased risk for abdominal redistribution and weight gain.
  3. Regular exercise/physical activity and a diet that is rich in fruits and vegetables and whole grains, and low in saturated fats, are essential.

With regards to the predominance of testosterone, well, that’s just one more hurdle to overrcome. In the coming weeks, I’ll see if I can find a few evidence-driven tips to counteract this imbalance. In the meantime, we’ve got yet another reason to keep moving!

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