Angela Onwuzoo
Citing how pregnancy complications and early menopause increase women’s future risk of heart disease, medical experts stress the need for early detection of hypertension in middle-aged women.
According to a study titled, “Hypertension symptoms in women often mistaken for menopause,” and published in the European Heart Journal, pre-eclampsia is linked with a four-fold increase in heart failure and hypertension and a doubled risk of stroke.
European Heart Journal is the flagship journal of the European Society of Cardiology, and it is reckoned as the world’s leading publication in general cardiology.
The experts also say women who have an early natural menopause before the age of 40 are more likely to develop cardiovascular disease, adding that each year, it is associated with a three percent raised risk.
The study authors say the research provides guidance on how to manage heart health during menopause, after pregnancy complications, and during other conditions such as breast cancer and polycystic ovarian syndrome.
First author of the document and Director of the Women’s Cardiac Health Programme, Radboud University Medical Centre, Nijmegen, The Netherlands, Prof. Angela Maas, said physicians should intensify the detection of hypertension in middle-aged women.
She explained, “Up to 50 percent of women develop high blood pressure before the age of 60 but the symptoms – for example, hot flushes and palpitations – are often attributed to menopause.
“High blood pressure is called hypertension in men but in women it is often mistakenly labelled as ‘stress’ or ‘menopausal symptoms’.
“We know that blood pressure is treated less well in women compared to men, putting them at risk for atrial fibrillation, heart failure and stroke – which could have been avoided.
“A woman’s life provides clues that you need to start early with prevention. We have to assess female patients differently to men, and not just ask about high cholesterol. This will enable us to classify middle-aged women as high-risk or lower risk for cardiovascular disease.”
Maas noted that autoimmune inflammatory conditions such as rheumatoid arthritis and lupus were more common in women compared to men and increase cardiovascular risk around menopause.
Giving further insight into the document, she said, “There are several phases of life when we can identify subgroups of high-risk women.
“High blood pressure during pregnancy is a warning sign that hypertension may develop when a woman enters menopause and it is associated with dementia many decades later.
“If blood pressure is not addressed when women are in their 40s or 50s, they will have problems in their 70s when hypertension is more difficult to treat.
“Women can help their doctors prevent heart problems and make earlier diagnoses by mentioning issues like complicated pregnancies and early menopause and monitoring their own blood pressure.”
Emphasising the role of healthy diet and nutrition in reducing the risk of cardiovascular diseases, Maas said collaboration between cardiologists, gynaecologists and endocrinologists was needed to provide the best care to female patients.
While menopausal hormone therapy is indicated to alleviate symptoms such as night sweats and hot flushes in women over 45, the authors recommend assessment of cardiovascular risk factors before initiation.
Therapy is not recommended in women at high cardiovascular risk or after a stroke, heart attack, or blood clot.
Speaking in an interview with PUNCH HealthWise, an Obstetrician and Gynaecologist at the Aminu Kano Teaching Hospital, Kano State, Dr. Labaran Aliyu, said women in their late 40s and 50s should learn to see a doctor when they are experiencing changes in their body.
According to the gynaecologist, there is lack of information among our women about the symptoms of menopause, adding that this impacts negatively on their health and also on their daily activities,
Aliyu said besides the health implications, menopausal symptoms could also affect women’s productive outputs if they fail to seek care.
“Some women even feel that they have diseases when what they are experiencing is menopausal physiological changes. Some feel they have typhoid.
“So, these are the implications of poor knowledge of menopause on the quality of life of women and with this false assumption of having typhoid, some of them are busy taking antibiotics.”
Authors in an article published in Sage journals, say cardiovascular disease is very common in women.
” It is still under diagnosed and under treated. Many women are not having their risk factors for cardiovascular disease properly addressed. Many healthcare professionals are uncertain about the role of hormones in cardiovascular disease”, they said.
According to the World Health Organisation, menopause is the “permanent cessation of menstruation resulting from the loss of ovarian follicular activity”, noting that 12 months of consecutive amenorrhea is recognised to occur in natural menopause.
The global health agency says menopause is prompted by a decline in estrogen and progesterone production, and rising follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels.
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