Exercise is good. Did we need another study to tell us that? Maybe we should be talking about bio-identical hormone replacement therapy instead of how exercise helps mitigate synthetic hormone replacement drug therapy.
Moderate exercise like brisk walking may cut women’s stroke risk 20 percent.
Moderate exercise also helps offset some of the increased stroke risk in women taking postmenopausal hormone therapy.
Women don’t need to run marathons or do intense aerobics to reduce their stroke risk. Moderate-intensity exercise — such as brisk walking or playing tennis — may do the trick, according to research presented at the American Stroke Association’s International Stroke Conference 2014.
“I was surprised that moderate physical activity was most strongly associated with a reduced risk of stroke,” said Sophia Wang, Ph.D., the study’s lead author and professor in the department of population sciences within the Beckman Research Institute at the City of Hope in Duarte, Calif. “More strenuous activity such as running didn’t further reduce women’s stroke risk. Moderate activity, such as brisk walking appeared to be ideal in this scenario.”
The study found that moderate exercise also helps offset the increased stroke risk seen with postmenopausal women taking menopausal hormones, but not completely.
Researchers analyzed information from the 133,479 women in the California Teachers Study to see how many suffered a stroke between 1996 and 2010. Those who reported doing moderate physical activity in the three years before enrolling in the study were 20 percent less likely than women who reported no activity to suffer a stroke. “The benefits of reducing risk of stroke were further observed among the group of women who had a sustained moderate level of physical activity over time,” she said.
Postmenopausal women taking menopausal hormone therapy had more than a 30 percent higher risk of stroke than women who never used menopausal hormone therapy. After the women stopped taking hormones, their risk began to diminish. (They still rerain from distinguishing bio-identical hormones from the synthetic hormones shown to cause problems – unlike bio-identical hormones).
“The effects of physical activity and hormone therapy appear immediate and the benefits of physical activity are consistent in premenopausal and postmenopausal women,” Wang said. Therefore, Wang recommends that women incorporate some type of physical activity into their daily routine. “You don’t have to do an extreme boot camp. The types of activities we’re talking about are accessible to most of the population.” Power walking and recreational tennis, for example, do not necessarily require special memberships to gyms.
The study also found that women with diabetes had elevated stroke risk, although this group encompassed women who also were overweight. “Physical activity, obesity and diabetes are all highly correlated with one another,” Wang said. “Stroke prevention among diabetics is thus a particularly important scientific question to address.”
Although 87 percent of the women were white, Wang said she believes the study’s results may also apply to women in other racial/ethnic groups because the amount of stroke risk reduction was so robust. Further studies are needed to determine how much moderate exercise helps those with diabetes avoid strokes.
Co-authors are: Leslie Bernstein, M.S., Ph.D.; James Lacey, Jr., M.P.H., Ph.D.; Kamakshi Lakshminarayan, M.D., Ph.D. Mitchell Elkind, M.D., M.S., M.Phil; Daniel Woo, M.D.; Ph.D.; Jenna Voutsinas, M.P.H.; and Chengyi Zhong, M.P.H.
Author disclosures are on the abstract.
The study was funded by the National Institute of Neurological Disorders and Stroke. The California Teachers Study group is funded by the National Cancer Institute.
14 December 2013 American Heart Association
Heart disease may put older postmenopausal women at higher risk for decreased brain function such as dementia, according to new research in Journal of the American Heart Association.
“Our study provides further new evidence that this relationship (between heart disease and dementia) does exist, especially among postmenopausal women,” said study author Bernhard Haring, M.D., M.P.H., clinical fellow in the Comprehensive Heart Failure Center and the Department of Internal Medicine I at the University of Würzburg in Germany. “And many different types of heart disease or vascular disease are associated with declining brain function.”
Researchers, conducting neurocognitive exams on nearly 6,500 U.S. women ages 65-79 who had healthy brain function at the start of the study, found:
- Postmenopausal women with heart disease or vascular disease were 29 percent more likely to experience cognitive decline over time compared with women without heart disease.
- The risk for cognitive decline was approximately double among women who had a heart attack compared with those who had not had a heart attack.
- Women who had heart bypass surgery, carotid endarterectomy (surgical removal of a blockage in a neck artery) or peripheral artery disease were at greater risk for cognitive decline.
- Risk factors such as high blood pressure and diabetes increased risk for cognitive decline over time.
- Obesity didn’t notably increase cognitive decline in elderly women.
“Women with heart disease — in particular women who have had a heart attack, bypass surgery, heart failure, atrial fibrillation, peripheral vascular disease or carotid endarterectomy — should be monitored by their doctors for potential cognitive decline,” Haring said. “It is also very important to adequately manage heart disease risk factors such as high blood pressure and diabetes.”
Dementia is an increasingly significant problem in developed countries, so researchers said more study is warranted on how preventing cardiovascular disease may preserve cognitive health.
Co-authors are Xiaoyan Leng, M.D., Ph.D.; Jennifer Robinson, M.D.; Karen C. Johnson, M.D., M.P.H.; Rebecca D. Jackson, M.D.; Rebecca Beyth, M.D., M.Sc.; Jean Wactawski-Wende, Ph.D.; Moritz Wyler von Ballmoos, M.D., M.P.H., Ph.D.; Joseph S. Goveas, M.D.; Lewis H. Kuller, M.D., Dr.PH.; and Sylvia Wassertheil-Smoller, Ph.D. Author disclosures are on the manuscript.
The National Institutes of Health funded the study.
For the latest heart and stroke news, follow us on Twitter: @HeartNews.
Full bibliographic informationHeart disease linked with dementia in older postmenopausal women
Bernhard Haring, M.D., M.P.H.
Cardiovascular Disease and Cognitive Decline in Postmenopausal
Women: Results From the Women’s Health Initiative Memory Study
J Am Heart Assoc. 2013;2:e000369 doi: 10.1161/JAHA.113.000369
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CHICAGO—Nutritional supplements, along with diet, exercise and stress management, can help women feel their best as they enter perimenopause and menopause, according to Tori Hudson, N.D., clinical professor, National college of Naturopathic Medicine, and director, A Woman’s Time Clinic, who spoke at the eighth annual Natural Health Research Institute (NHRI) symposium.
As a practitioner, Dr. Hudson said her primary job with perimenopasue and menopause patients is to make them feel better, reducing symptoms such as hot flashes, while not increasing the risk of other diseases. This is where plant medicine can shine.
Dr. Hudson said black cohosh (Cimicifuga racemosa) is the most researched plant for menopause symptoms with more than 100 published scientific papers and presentations. Black Cohosh does not have estogenic action and does not contain phytoestrogens, which is why it is thought to be safe in breast cancer patients.
Most of the black cohosh studies show 50-percent reduction in hot flash symptoms or more, and some show mood support, she said. She mentioned a 2004 in vitro study that found isopropanolic black cohosh extract was safe for women with a history of breast cancer (Menopause. 2004 May-Jun;11(3):281-9.) And a 2007 study showed is was associated with a 61-percent reduction in breast cancer risk (Int. J. Cancer 2007; 120:1523-1528).
Ginseng is another herb Dr. Hudson uses in menopausal patients. She noted a 2012 study found red ginseng reduced menopause symptoms significantly, including hot flashes (Menopause 2012;19(4):461-466). This study also found it decreased total cholesterol and low-density lipoprotein (LDL) cholesterol. Dr. Hudson cautioned that ginseng could cause insomnia, so she recommends her patients take it in the morning.
In a 2006 study, Dr. Hudson said 100 mcg of hops significantly decreased menopause symptoms after six weeks, but not after 12 (Maturitas. 2006 May 20;54(2):164-75). She said she recommends hops for help with menopause, but doesn’t rely on it alone; instead, she combines it with other menopause-helping ingredients.
Kava can also help address menopause symptoms, as a 2000 study found it reduced anxiety in menopause patients, especially in women who were also taking hormone replacement therapy (Minerva Ginecol. 2000 Jun;52(6):263-7). Another study found kava reduced anxiety within one month in perimenopausal women (Maturitas. 2003 Feb 25;44(2):103-9).
While Dr. Hudson noted some reports have shown kava can be associated with liver damage, she said doses of up to 210 mg kavalactones per day should be safe.
Kudzu (Pueraria mirifica) may be growing all over the southern United States, but it also helps women as they enter menopause, Dr. Hudson explained. A 2007 study found 20, 30 or 50 mg/d of kudzu decreased vaginal dryness in women with menopause after 12 weeks (Menopause. 2007 Sep-Oct;14(5):919-24). And in 2011, a study found 25 and 50 mg/d increased sexual health in menopausal women (Arch Gynecol Obstet. 2011 Aug;284(2):411-9). However, Dr. Hudson noted kudzu is rich in phytoestrogens, so she avoids using it in breast cancer patients
Maca (Lepidiym meyneii) , a south American herb, at 3.5 g/d reduced anxiety, depression and sexual dysfunction in a randomized clinical trial of postmenopausal women (Menopause. 2008 Nov-Dec;15(6):1157-62). And a 2012 review found maca had a positive effect on sexual dysfunction in menopausal women (BMC Complement Altern Med. 2010 Aug 6;10:44).
Red clover, an isoflavone extract, works mildly Dr. Huson said. She said doesn’t use it much because it’s hit and miss. However, she noted a 2010 study found red clover extract with 80 mg of isoflavones, reduced anxiety and depression in postmenopausal women (Maturitas. 2010 Mar;65(3):258-61).
A double blind Taiwanese study with peri-menopausal women found French maritime pine bark (as Pycnogenol from Horphag Research) decreased blood pressure, increased high-density lipoprotein (HDL) cholesterol and decreased the perimenopause symptoms of depression, anxiety, sexual dysfunction and insomnia (Acta Obstet Gynecol Scand. 2007;86(8):978-85).
Dr. Hudson covered Sibiric rhubarb (Rheum rhaponticum), an herb that’s currently only sold to professionals. A 2006 study found 250 mg of the botanical reduced hot flashes and anxiety, and increased well-being (Menopause. 2006 Sep-Oct;13(5):744.-59)
Lastly, Dr. Hudson noted St. John’s Wort at 900 mg/d for 12 weeks in menopausal women improved psychological and psychosomatic symptoms as well as feelings of well-being (Adv Ther. 1999 Jul-Aug;16(4):177-86).