Women, ageing, hearts & arteries Part 3: How to keep our arteries healthy

Lovely Group Of Three Active Senior Woman On Their 60s Walking,

There’s a range of ways we can preserve them, and the challenge is to put together an approach that suits us.

Ideally, we want to avoid our arteries getting into the kind of deteriorated state that allows LDL to break into them.

Or if it does happen, to adopt a lifestyle that limits ongoing inflammation and damage, because if the conditions that support arterial injury and a build-up of plaque continue, it’ll keep happening.

Remember that the vulnerability of arteries increases after menopause, so the more we can counter that with our lifestyle the better.

In a nutshell this means turning the list of stressors around: adopting an anti-inflammatory diet, not smoking, keeping insulin stable, avoiding exposure to toxic chemicals, being physically active in a way that improves blood flow without stressful extremes, and managing emotional stress.

Below I’ve expanded on three: diet, exercise and stress.

An anti-inflammatory diet

This implies antioxidant-rich foods. Antioxidants protect our tissues from harm, which in turn prevents inflammation.

Good examples include leafy greens, coloured fruit and veg, herbs, spices, oily fish, olive oil, fresh nuts and seeds, legumes, cacao and black and green tea.

Red wine often gets a guernsey because of the coloured grape skins but we need to get that balance right. Wine can also contribute to excess weight and breast and bowel cancer, so follow the guidelines for health drinking.

Another reason for emphasising vegies and fruit is that they help the body produce nitric oxide. Beetroot and leafy greens are high achievers here, but plants get a big tick all round.

Avoiding tissue damage and inflammation also implies skipping processed or convenience food. Even the food you don’t think of as processed – i.e. most pasta, crackers, white rice, a lot of bread, ‘heart healthy margarine’ and so on. Plus sugar and anything that contains it, including fruit juice.

While ‘wholegrain’ is worshipped in some camps for its fibre, grain can be inflammatory (triggering insulin release, in some people more than others) and often comes under the ‘processed food you don’t think of as processed’ category. Bottom line: be judicious.

It’s also important to avoid obesity because simply carrying too much weight is a risk factor for heart disease. All of us post-menopause need to watch the carbs, sugars and portion sizes.

Two diets often recommended for heart and artery health are the Mediterranean, which you could have guessed, and DASH (Dietary Approaches to Stop Hypertension).

Although they have similarities, DASH is low in fat, while the Mediterranean approach is known for including olive oil and omega-3 (e.g. fish) fats.

The oils that DASH does recommend are vegetable oils. It’d be great to think science might have phased out this kind of thinking by now, but it’s still around.

DASH also emphasises low salt, and reducing processed salt is wise. For many people, processed food is the main source of this.

What about supplements? Magnesium can be useful because it relaxes arteries, which helps reduce blood pressure. Foods that contain it include leafy greens, almonds and pumpkin seeds.

One we might hear more of in future is bergamot, the citrus fruit used to flavour Earl Grey tea. It contains antioxidants and early trials suggest it could help to reduce inflammation, blood sugar, blood pressure, plaque formation and cholesterol.

It’s reasonable these days to advise not taking calcium supplements unless you absolutely have to. And if you do, make sure you take a form that has a better chance of ending up in your bones than your arteries.

Moving for a healthy heart and arteries

Melbourne-based researcher Dr Rachel Climie is an authority on exercise and vascular ageing. She points out that even without increases in blood pressure, our big arteries grow stiffer if we’re sedentary. So the message is to move and do it consistently.

American cardiologist and exercise scientist Ben Levine recommends this weekly formula for keeping supple arteries:

  • moderate exercise for about 30 minutes on 2-3 days
  • something longer (like walking, biking or gardening) on another day
  • one session with a bit more intensity (maybe a few quicker portions in your 30-minute walk), plus
  • a session of strength training.

He argues that arterial stiffness is irreversible after age 65, but remember that anything always beats nothing. Exercise, especially the aerobic kind, increases blood flow and the release of nitric oxide, which helps reduce blood pressure.

Stress: we need to take this seriously

While the things that cause us stress and the way we experience it differ for all of us, it’s clearly a major issue.

I’ve referred to Angela Maas a few times, and since she’s in her 60s she’s of an age where she needs to take her own advice. She says she no longer does things like having people over for a meal because she finds it stressful.

Doing what works for us and being willing to draw a line where we need to draw it is imperative. Too many of us ignore that to fit in with social and family expectations, but we do it at our peril.

Of course, there are different types of stress, from the daily-life type activities like having people to dinner through to the most devastating events and hardships. But regardless of our circumstances we should never feel selfish or inadequate for getting the support we need.

On the flip side — and back to nitric oxide — sex, meditation, breathing through our nose rather than our mouth, and thinking joyful or hopeful thoughts are all known to increase its production in the lining of our arteries.

We also can’t talk about stress without talking about sleep. Japanese research has shown a link between sleep and the health of our heart and arteries so do your best in that area.

How do medications help?

The obvious ones are statins, blood pressure meds and hormone replacement.

Statins are anti-inflammatory and, as we’ve noted, help to stabilise plaque. There are pros and cons to taking them as you know, but especially for the person who’s not going to shift their lifestyle, they’re a way to dampen inflammation.

They stop our body from producing cholesterol. Yes, cholesterol, that dangerous stuff that’s necessary for brain function, cell health and the production of sex hormones and vitamin D.

Statins are certainly recommended for men over 50 who’ve already had a heart attack, or the one in 500 of us who have high cholesterol because of a familial condition that limits our ability to clear it from the body. Beyond that there’s disagreement about the benefits.

Blood pressure medications work in a variety of ways, including slowing the heart and stopping it from squeezing hard, stopping the hormonal and nerve signals that tell your arteries to constrict, and relaxing your blood vessels. Some of us might be prescribed more than one type.

Hormone therapy might seem like an obvious answer to our loss of estrogen, but despite years of research, whether it is or not remains a contested issue.

For example, the Heart Foundation doesn’t support the use of hormones but the Australasian Menopause Society, whose mission is ‘to improve the quality of life of women during and after the menopause’, does.

The AMS even argues that hormone therapy can be used for women with cardiovascular risk factors. A major concern in the past was that hormone treatment could increase the risk of heart disease.

Since it needs to be started within 10 years of menopause, women in that age bracket need to weigh up the various risks, benefits, types and methods of administration and work out whether it’s a path they want to take. Clearly there’s no definitive answer for everyone.

To sum up, the health of our arteries is critical. Picking up the cholesterol thread again, the real problem isn’t so much cholesterol as what happens to it inside damaged arteries. And that damage is what leads to heart disease.

It’s a pity that arteries are mostly forgotten. But the more we understand about how and why they age or deteriorate the better placed we are to take care of them.

And our lives may well depend on us doing that.

 

Photo Source: Bigstock

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