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Published On: Sun, Feb 5th, 2012

Women & Cardiovascular Disease

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A Comprehensive Look

-Andrea Purcell, N.M.D

When it comes to cardiovascular disease, women are at a disadvantage.  The statistics on heart disease have all been extrapolated from male patients.  For the last 50+ years, male doctors have ruled the specialty of Cardiology. The standards that have been set for what is and what is not a heart attack have been based on men, by men.  

Anatomically, women have smaller hearts and therefore smaller vessels that supply the heart. This means that common surgical procedures developed on male subjects, such as stents and angioplasty, just don’t work as well on women.

Furthermore, many procedures and standard tests, such as the electro-cardio gram (EKG), aren’t as effective in evaluating a woman’s risk for heart disease. 

When a woman reaches menopause and beyond, due to body build up of toxins, vitamin deficiencies, and a drop in hormone levels, she has exactly the same cardiovascular disease risk as a man.  

In fact, women are two times more likely than men to die from their first heart attack! Of the 1.1 million heart attacks reported annually, 500,000 occur among women.

Some female-specific medications have been shown to increase the risks of heart disease; specifically, oral contraceptives and synthetic hormone replacement therapy. 

It has been reported in The New England Journal of Medicine that the risk of myocardial infarction (heart attack) increases among women who used second-generation oral contraceptives.  For years women have been advised not to smoke and take oral contraceptives due to the increased risk of stroke.

Synthetic hormone replacement therapy used in menopausal women was shown to increase blood pressure and stroke occurrence.

The best test to detect cardiac health in women is the stress echocardiogram. This evaluates blood flow through the coronary arteries under stress, typically while peddling a bicycle.

Many integrative doctors recommend blood tests in addition to cholesterol testing, which can determine vessel inflammation and damage. 

Additional tests include;  homocysteine and highly sensitive C-reactive protein, as part of a complete heart checkup. 

High Blood Pressure

According to the national council on Aging, 50% of women aged 60+ have high blood pressure, and 77% of women aged 75+… ditto. 

This is 11% higher than men of the same age group.

Many women experience high blood pressure when they are over weight. 

Peri- and post-menopausal women can gain weight, develop anxiety, and experience heart palpitations due to hormone fluctuations.  All of these occurrences  can cause an increase in blood pressure. 

The best advice to lower blood pressure is to exercise and make dietary changes.  

Allow three to six months to lose weight, eat better, and stress less

Engage in a heart pumping activity for 30 minutes, 5 times weekly.  Focus on normalizing your weight and bringing your body mass index number to 25

It is important to note that Natural Integrative Medicine doesn’t prescribe natural substances to act the same way as drugs; it treats the real cause of the problem. It asks the question; “why?”

Why does this woman have high blood pressure? 

All too often prescription drugs are administered when a problem could have been reversed with diet and lifestyle changes over time.


Cholesterol is typically a three-digit number showing concentrations of three fats found in your blood: 1. low-density lipoprotein (LDL); the bad cholesterol which accumulates in arteries 

 2. high-density lipoprotein (HDL); the good cholesterol which can transport bad cholesterol to the liver and eventually out of the body… and… 

3. Triglycerides

Trying to improve cholesterol is worthwhile if it succeeds in the ultimate goal of lowering the instance of heart attack, stroke, and high blood pressure

The goal is to lower LDL, which can build up in the walls of arteries and form hard plaque.  Cholesterol plaques are scabs over damaged vascular endothelial tissue. Endothelial tissue becomes damaged from toxins the body is exposed to over a lifetime. 

These toxins include; food based chemicals, heavy metals, and air and water chemicals that lead to vascular damage. Very high cholesterol levels can indicate defective body elimination of cholesterol through the liver or excessive dietary intake. 

Diet, weight, physical activity, age, hormone levels, gender and heredity are all factors that affect cholesterol levels

Cholesterol has gotten a bad reputation over the last two decades as the causative agent in heart disease. 

Elevated LDL is simply a protective mechanism of the body to repair damaged vessels. It makes sense then to prevent vessel damage, which in turn, lowers LDL.

If cholesterol levels are too low, other problems can arise. [Cholesterol is so important that the body produces 800-1500 mg each day to provide for metabolic processes.] 

Let’s take a closer look at some of them.

*Every cell in the body needs cholesterol to grow and repair itself, and the body uses it to produce hormones—including those governing sexual function. 

*The central nervous system, composed of the brain and spinal cord, contains nearly one-fourth of the body’s store of cholesterol. 

*Bile acids, formed from cholesterol, are vital for proper fat digestion.

*Cholesterol is the foundation of adrenal and reproductive steroid hormones. 

*Cholesterol stored in the skin assists in converting sunlight to vitamin D. 

Statin Drugs 

The most widely prescribed drugs for cholesterol treatment are statins; the most common of which is Lipitor. Lipitor is the top selling drug in history, with annual sales exceeding $11 billion! Lipitor is now available in its less expensive generic form, atorvastatin

Statins are powerful drugs that come with unpleasant side effects and  risks. These side effects are more common in postmenopausal women. 

Muscle pain is a major reason why women stop taking these drugs. Patients describe it as a general aching in their joints and muscles; the pain can actually start as soon as a woman begins taking a statin-or-it may not start for several years.  An elevated risk of breast cancer is a major concern when taking statins.  Statins block squalene, an antioxidant and an immune system booster, that is vital in preventing breast cancer. 

Additionally, statins inhibit the synthesis of cholesterol in the brain by blocking the mevalonate pathway. This slows down communication between neurons, and is thought to account for the cognitive symptoms of amnesia, confusion, forgetfulness, disorientation, and dementia reported by some patients on statins.

Statins also deplete the body of COQ10. COQ10 is essential for heart muscle function. 

In a recent study published in the Annals of Internal Medicine;Statin medication use in postmenopausal women is associated with an increased risk for diabetes mellitus“,  stated Yunsheng Ma of the University of Massachusetts Medical School in Worcester. 

Both men and women have been shown to have an increased risk of diabetes with statin use. Men saw a small increase of 10-12% and women were shown to be 48% more likely to develop diabetes if taking a statin drug. The reasons for these things are not completely known, but the effect of statins on the muscles and liver may cause the body to make slightly more sugar than it normally would. 

If a woman is currently taking a statin, she should regularly monitor her blood sugar and try to reduce her risk of diabetes by losing weight and getting more exercise.

Raising HDL and Lowering Triglycerides

The best way to raise good cholesterol (HDL) is to consume omega 3 fats which are high in DHA and EPA.  These are known as essential fats because they are essential for life and must be supplied through the diet.  Since the American diet is deficient in essential fats, I recommend flaxseed oil and/or fish oil.  Both of these are available in liquid or capsule forms. A typical dose is 1-2 tablespoons of oil or 2 capsules twice daily. 

The true importance of flax seed oil is due to the fact that it is nature’s richest source of linolenic acid, which is frequently deficient in most American diets. 

Additionally, researchers from the University of Copenhagen, Denmark,  studied the effects of ground flaxseed fiber on triglycerides. They reported a decrease in blood triglycerides when supplementing men with 3.5 grams of flaxseed fiber daily.1

In addition to flaxseed fiber, it is also well known that a diet low in carbohydrates and sugar lowers triglycerides.

In my experience, not everyone wants to take a prescription drug, or  to accrue unwanted side effects.  Many patients prefer nutritional supplements to help reduce cholesterol, prevent vessel damage, and reduce blood pressure. 

Patients have increased success when they work with a physician who specializes in Natural Integrative Medicine.

Natural substances for lowering blood pressure, cholesterol, and offsetting drug-induced side effects are listed below.  Remember that there is an ongoing problem in medicine where we offer a medicated quick fix when the problem could have been solved with diet and lifestyle changes. 

Natural Supplements, Diet, and Exercise, for Heart Health:

1) Essential fatty acids help to increase HDL

2) Anti-oxidants, (such as Vitamins C & E and green tea), help to reduce LDL and decrease the inflammation inside our vessels. Green tea is rich in the class of polyphenol compounds known as catechins. Many of the effects of green tea are thought to be due to its most abundant catechin, epigallocatechin gallate (EGCG).  In one study, daily green tea catechins in doses of 145-3,000 milligrams for 3-24 weeks significantly reduced total and LDL cholesterol levels.2

3) Heart pumping exercise increases circulation and assists in keeping vessels healthy

4) Eating a diet that is filled with green, yellow, orange, and red vegetables. Vegetables contain thousands of detoxifying and anti-inflammatory compounds, necessary for proper body function.

Lowering  Cholesterol Without Drugs

*Red yeast rice extract. This fermented food has been shown to lower cholesterol as much as a statin.

*Niacin. This form of vitamin B3 boosts HDL, the good cholesterol, by 15 to 35 percent. It also lowers both LDL (“bad”) cholesterol and triglycerides.

*Fish oil. With its high levels of omega-3 fatty acids, fish oil has been shown to reduce the uptake of triglycerides in the body.

*Flaxseed fiber – 5g of flaxseed fibers has been shown to reduce cholesterol uptake in the bowel.

If you are a patient already on a statin drug, here are a few supplements to ease side effects and support your body…

*Coenzyme Q10, also known as CoQ10, acts as an antioxidant to protect your body from damage. It provides specific benefits to the heart muscle.  Recommended dose: 200mg daily.

*Squalene. This antioxidant and breast cancer protector is found in olive oilAdvice: add 1-3 tablespoons olive oil to your diet each day

*Lycopene.  A powerful antioxidant found in tomatoes, watermelon, pink grapefruit, and papaya, lycopene lowers inflammation levels throughout the body.  Advice: take 100-250 mg daily.

1 Kristensen M, Savorani F, Christensen S, et al. Flaxseed dietary fibers suppress postprandial lipemia and appetite sensation in young men. Nutr Metab Cardiovasc Dis. 2011.
December 2011
2Kim A, Chiu A, Barone MK, et al. Green tea catechins decrease total and low-density lipoprotein cholesterol: a systematic review and meta-analysis. J Am Diet Assoc. 2011 Nov;111(11):1720-9.



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