The Truth About HRT And Heart Disease.

Deciphering Menopause & Heart Health

What happens from a heart health perspective during menopause is very well understood.

What HRT does to heart health over that time period is less well understood.

This should not be the case. But unfortunately, it is.

To fully grasp this issue, we must always keep three factors in mind.

1. Risk Factors: LDL cholesterol, Blood pressure, insulin resistance etc.

2. Disease: Atherosclerosis, Coronary Artery Disease, ‘Plaque’.

3. Events: Heart attack, stroke, deaths related to heart disease.

The distinction between these three factors is critical to understand, as too often people claim that something is ‘good for your heart’ but do not state which factor is improved.

And that matters.

My foundational thesis on preventing heart disease is the aggressive management or prevention of risk factors to delay the onset of disease (atherosclerosis) to ultimately avoid events such as heart attacks.

However, in terms of a hierarchy of evidence, we put prevention of events at the top; next is disease and then risk factors.

The reason is that what matters most over long periods of time is that we prevent events.

Remember, heart disease doesn’t kill people.

Heart attacks do.

OK. With that framework in place, let’s move on to the details.

Menopause & Heart Health.