If you have an established problem like high blood pressure or cholesterol, you will probably need medication to help control it. However, unless you also make sound lifestyle choices, and follow them permanently, you will only get half the benefit. Pills will control the symptoms, but won’t stop the underlying disease from progressing.
Combining medication with correct lifestyle choices, however, will significantly slow down the disease – perhaps enough to reduce your medication to a minimum dose.
The most important steps to take are :
• Stop smoking
• Maintain normal:
• body weight ( by diet & exercise)
• blood pressure
• blood cholesterol and sugar
• Have regular medical check-ups
These measures are best started from a young age, but you will still benefit even if you only start at the menopause. Aim to have your new lifestyle patterns firmly established within a year or two, so that when you stop taking HRT, you are already in the best possible shape heart-wise.
If you need HRT (eg for hot flushes), the current recommendation is to use the lowest effective dose for the shortest possible time, and that skin patches are the safest (and most convenient) route. Unless there are good medical reasons to avoid it, daily low-dose aspirin should also be considered for menopausal women with known risk factors for CVD.
HRT begun early in the menopause, eg age 50-60 years, does offer some protection to normal arteries, and may even delay the onset of arterial disease. However, for arteries which are already diseased, HRT gives no further protection.
In patients with established CVD, HRT should in any case not be started after age 60.
Regular moderate exercise, especially if weight-bearing (eg brisk walking), will help with weight loss, will lower blood pressure and give added protection against osteoporotic fractures. It will also significantly reduce your LDL cholesterol and raise your HDL cholesterol, lowering your risk for CVD even further.