Lifestyle changes help protect heart postmenopause

NEW YORK (Reuters Health) - Women can fight menopause's heart-threatening consequences by losing weight, exercising more and eating better; and these lifestyle changes may be particularly helpful to those who stop taking hormone replacement therapy (HRT) a new study shows.

"These results have important public health implications and suggest that a nonpharmacologic lifestyle approach is both safe and effective for cardiovascular risk factor reduction in postmenopausal women, especially those who discontinued HRT use," Dr. Kelley K. Pettee of Arizona State University in Mesa and her colleagues conclude.

The risk of heart disease rises after menopause as the incidence of cardiovascular risk factors such as high blood pressure and high cholesterol also increases, Pettee and her team note in the American Journal of Preventive Medicine.

HRT, which boosts levels of HDL, the "good" cholesterol and lowers levels of LDL, the "bad" cholesterol, had been widely prescribed to protect the heart while easing menopausal symptoms. But a large clinical trial found HRT might actually increase heart disease risk, so many women have been advised to stop taking the hormones.

When the results of this study, the Women's Health Initiative, were published, Pettee and her team were in the midst of a 5-year study investigating whether lifestyle changes could reduce heart disease risk among postmenopausal women.

The researchers hypothesized that while stopping HRT would increase certain heart disease risk factors, lifestyle changes would help counteract this effect. To investigate, they compared 240 women who were on HRT when the study began; 130 of these women stopped taking hormones after 18 months.

The women were randomized to a lifestyle intervention group, which included 150 minutes of moderately intense physical exercise a week; a 1300 to 1500-calorie-a-day diet; and reduction of total and saturated fat; or a control group of women who attended a series of lectures on health.

The women in the lifestyle intervention group showed significant reductions in weight, body mass index, waist circumference, total cholesterol levels, and LDL levels. Total cholesterol and LDL cholesterol rose among women who quit taking HRT.

While the women in the control group who stopped taking HRT showed a 22-mg/dL rise in total and LDL cholesterol, those in the lifestyle intervention group had their total and LDL cholesterol rise by less than 4 mg/dl.

"Based on the findings of the current investigation, special attention should be paid to encouraging lifestyle strategies that are likely to impart more benefit and less risk than drug therapies," the researchers conclude.

SOURCE: American Journal of Preventive Medicine, June 2007.