Interviewee: Zhang Haicheng, chief physician of cardiovascular department of Peking University People’s Hospital
According to the previous view, heart disease is a “man’s disease”, and the risk of women is lower. However, in the past ten years, the mortality rate of coronary heart disease in men has decreased year by year, while in women, it has not improved significantly, and even has an upward trend. In particular, beware of vascular disease, encounter female menopause, will become more ferocious. Recently, the American Heart Association issued a scientific statement “focus on women’s menopausal transition period”, emphasizing that menopausal transition period should be regarded as an important window period for cardiovascular health intervention. Zhang Haicheng, chief physician of cardiovascular department of Peking University People’s Hospital, also said in an interview with life times that pre menopause and post menopause can be said to be the key period for maintaining blood vessels.
Usually, when women are about 50 years old, their ovarian function begins to decline, and the protective effect of estrogen is weakened, that is, they enter the menopausal transition period. At this stage, women’s risk of cardiovascular disease increases. The study found that after menopause, women’s risk of cardiovascular disease increased three times than before. In general, the following questions are the most common.
Blood pressure fluctuates greatly. Women in perimenopausal disorder, blood pressure fluctuations, especially emotional, physical fatigue or poor sleep quality, blood pressure will fluctuate.
The blood lipid is increased. Affected by estrogen changes, female lipid metabolism will be disturbed. Menopause is a unique risk factor for cardiovascular disease in women. After menopause, the rate of dyslipidemia increased significantly. The survey showed that the levels of total cholesterol and “bad” cholesterol in women over 50 years old were higher than those in men of the same age, and dyslipidemia was an important risk factor for cardiovascular and cerebrovascular diseases.
Arrhythmia. The most common arrhythmia problems in women include sinus tachycardia, sinus arrhythmia, atrial premature beat and ventricular premature beat. The symptoms are paroxysmal palpitation and palpitation, often without inducement. The attack time usually lasts for dozens of seconds or several minutes, which can be relieved by itself. But some palpitations are caused by the disorder of autonomic nervous system such as sympathetic nerve and vagus nerve, which are related to the changes of estrogen level in perimenopausal period.
Perimenopausal women are also prone to carotid plaque, systemic atherosclerosis and other problems. Zhang Haicheng said that women in this period often have two extreme manifestations: one is that they are particularly nervous, and go to the emergency department immediately when the wind blows, which greatly affects the sleep quality, work efficiency and life satisfaction; the other is that they pay little attention to their own physical changes, subconsciously think that this is a normal phenomenon of menopause, and then ignore cardiovascular disease and delay treatment.
Zhang Haicheng reminded that when young, the estrogen in women’s body does improve the elasticity of blood vessels and reduce blood pressure, and blood vessels are not easy to harden. Moreover, before menopause, the proportion of coronary heart disease in men and women is about 7:1, and women suffering from cardiovascular disease are mainly concentrated in the population with multiple risk factors such as hypertension, diabetes, hyperlipidemia, smoking or early family history of coronary heart disease. But after menopause, the level of estrogen drops sharply, women suddenly lose the “natural umbrella”, the incidence of cardiovascular disease will increase sharply. By the age of 70, the proportion of male and female is basically the same, and once suffering from coronary heart disease, the mortality rate of female is higher than that of male.
According to the scientific statement “pay attention to women’s menopausal transition period”, Zhang Haicheng suggested that before and after menopause, women should protect their vascular health from the following aspects.
Control your diet. Due to the decrease of estrogen level, women are particularly prone to gain weight before and after menopause, so it is more important to control diet and a series of weight related factors such as weight, body fat, blood pressure and blood sugar within a reasonable range. The diet should be less oil, less salt and less sugar. 300-500 grams of vegetables, 200-350 grams of fruits, 250-400 grams of cereals and potatoes, and 40-75 grams of aquatic products should be eaten every day. The intake of saturated fat and trans fat should be limited. In addition, to quit smoking, limit alcohol, drink less coffee and caffeine and other functional drinks have a certain stimulatory effect on the heart.
Keep exercising. At least 30 minutes of continuous exercise every day, 150 minutes of moderate intensity aerobic exercise every week, and ensure sleep, develop a good habit of going to bed regularly, going to bed early and getting up early.
Appropriate decompression. Anxiety and depression are the common mental inducements of cardiovascular disease. Women are more likely to have bad emotions because of their delicate and sensitive emotions. In daily life, we should maintain a positive and optimistic attitude, combine work with rest, actively develop interests and hobbies, and try our best to make life rich and colorful. The care between family members plays an important role in psychological decompression. At this time, husband and family can help to share housework, so as to reduce women’s psychological pressure and burden.
Finally, Zhang Haicheng reminded that before and after menopause, women must check their blood pressure, electrocardiogram, cardiac ultrasound, etc. every year to help them find clues of cardiovascular disease as soon as possible and treat it as soon as possible. (our reporter Shi Xiaoxuan)