Low estrogen linked to heart attack in premenopausal women

November 13, 2000

NEW ORLEANS, Nov. 14 - A woman is more vulnerable to sudden, serious heart disease during the time of the menstrual cycle when her estrogen levels are at their lowest, according to a study presented today at the American Heart Association's Scientific Sessions 2000. Researchers also found that other health risks only worsen the odds for heart disease in premenopausal women.

"We found that significantly more premenopausal women experienced their heart attacks during or after their periods when their natural estrogen levels are low," says lead researcher Bettina Hamelin, Pharm.D., who is an associate professor of pharmacy at Laval University in Quebec, Canada. "However, these young women also had a number of other important risk factors such as smoking and diabetes."

This estrogen/heart disease link was first recognized after the long-term Framingham, Mass., cardiovascular study in the late 1970s. After tracking the residents of the town for many years, researchers noted that age 55 seemed to be a magic number for women: before age 55, they seldom had heart attacks, but after 55, the rate increased significantly.

"They wondered, of course, what happens at 55 - was it something to do with menopause? The hypothesis states that high levels of estrogen circulating in a woman's bloodstream may help protect her heart, which could be one reason a woman's risk of cardiovascular disease increases after menopause, when hormone levels decrease," says Hamelin. "We wanted to understand whether the natural increase and decrease of estrogen during a woman's menstrual cycle prior to menopause are related to the incidence of heart attacks in younger women."

The Quebec study is testing the theory that large fluctuations of 17-estradiol - a form of estrogen that circulates through the bloodstream - alter heart-disease risk enough that female test subjects would report serious heart problems during and immediately after their periods. The study included 28 premenopausal white women in the Quebec area, ages 35-47, who were admitted to the hospital for heart attack or serious chest pain. These women filled out a detailed questionnaire about their disease and medication history, symptoms, hormonal status and risk factors such as family history of heart disease, diabetes, high blood pressure, high cholesterol and smoking.

Twenty of the women reported heart-related problems within five days of the beginning of their period when estrogen levels are at their lowest. The study will continue until at least 50 premenopausal women with heart attacks and known menstrual-cycle history have been recruited.

This project is part of a larger study examining the role of both traditional and genetic risk factors, as well as estrogen, on unexpected heart attacks in women. Researchers will continue to recruit a total of 600 subjects, with and without heart disease, from the French Canadian population of Quebec, which represents a genetically conserved (similar gene pool) population.

"Results, however, apply to the general Caucasian population," says Hamelin. "The incidence of heart disease has actually increased in women. Women do have heart attacks prior to menopause and get very sick."

Hamelin says more data is needed to confirm that there is a vulnerable time during the menstrual cycle which may constitute a trigger in women at risk for heart disease.

"In the meantime, young women should be made aware of the fact that they may be at risk for heart disease and they should be very concerned about known risk factors such as a family history of heart disease, smoking, high cholesterol, diabetes and obesity," she says. "In addition, all women should be counseled about the potential risks and benefits of estrogen replacement therapy consistent with the American Heart Association's guidelines for both primary and secondary prevention."
-end-
Co-authors of the study include: Julie Methot, M.Sc.; Marie Arsenault, M.D.; Paul Poirier, M.D.; Sylvie Pilote, M.Sc.; Sylvain Plante, M.D.; and Peter Bogaty, M.D.

NR00-1191 (SS2000/Hamelin)

American Heart Association

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.