Recently reported in the BMJ – British Medical Journal – research from Australia has concluded that from the age of 30 onwards, physical inactivity exerts a greater impact on a woman’s lifetime risk of developing heart disease than the other well-known risk factors. Being overweight was certainly considered the major factor prior to this recent research, published online in the British Journal of Sports Medicine, but it looks like this is no longer the case.

The 4 Risk Factors

The researchers wanted to quantify the changing contribution made to a woman’s likelihood of developing heart disease across her lifetime for each of the known top four risk factors in Australia: and they also apply worldwide:

1. excess weight (high BMI)

2. smoking

3. high blood pressure

4. physical inactivity.

Together, these four risk factors account for over half the global prevalence of heart disease, which remains the leading cause of death in high income countries.

The researchers based their calculations on estimates of the prevalence of the four risk factors among 32,154 participants in the Australian Longitudinal study on Women’s Health, a comprehensive and wide-ranging study which has been tracking the long term health of women born in 1921-6, 1946-51, and 1973-8, since 1996.

However they make no mention of what is a high risk factor now for many menopausal women and that is long-term HRT use where the unopposed oestrogen and no balancing progesterone, only a synthetic progestin, has been linked to heart disease.

They found that the prevalence of smoking fell from 28% in women age 22-27 to 5% in 73-78 year olds. But the prevalence of inactivity and high blood pressure increased steadily across the lifespan from age 22 to 90. Overweight increased from age 22 to 64, then declined in older age.

The age factor

Up to the age of 30, smoking was the most important contributor to heart disease, but from then until the late 80s, low physical activity levels were responsible for higher levels of risk than any of the other risk factors.

How to reduce your risk

The researchers estimate that if every woman between the ages of 30 and 90 were able to reach the recommended weekly exercise quota — 150 minutes of at least moderate intensity physical activity — then the lives of more than 2000 middle aged and older women could be saved each year in Australia alone.

It is always best to choose some form of activity that you enjoy and will keep up with so if you hate the gym but love swimming, dancing, walking then work that into your weekly regime as often as you can. If time is an issue then there are many DVD exercise programmes that are based on dance or more fun routines and that you can do at home that will tackle both inactivity, and help lose weight.

The report makes no mention of the HRT factor, but it is undoubtedly the increased heart disease and cancer risk that has prompted the recent shift to making such use short term and for a maximum recommended 5 years. Hormone balance is essential at any age and redressing oestrogen dominance with progesterone – which supports heart health – is definitely a way to help reduce the risk.

Women on HRT should never come off it immediately as severe menopausal symptoms can result and generally if their use has been long term they are best on bioidentical progesterone only as they cut down and then may need to switch to a combination progesterone and low oestrogen cream if they still have a need for a low dose of oestrogen.