CREDIT::MILARD AYO.
What Is
Moderate Drinking?
Moderate drinking is defined as no more than one drink per
day for women, and no more than two drinks per day for men,
according to the “U.S. Dietary Guidelines for Americans.” Count
as one drink:
● 12 ounces of beer
● 5 ounces of wine
● 11/2 ounces of 80-proof hard liquor
Moderate Drinking
Sleep Apnea
Sleep apnea is a serious disorder in which a person briefly and
repeatedly stops breathing during sleep. People with untreated sleep
apnea are more likely to develop high blood pressure, heart attack,
congestive heart failure, and stroke.
Sleep apnea tends to develop in middle age, and men are twice as
likely as women to have the condition. Other factors that increase
risk are overweight and obesity, smoking, using alcohol or sleeping
pills, and a family history of sleep apnea. Symptoms include heavy
snoring and gasping or choking during sleep, along with extreme
daytime sleepiness.
If you think you might have sleep apnea, ask your doctor for a
test called a polysomnography, which is usually performed
overnight in a sleep center. If you are overweight, even a small
weight loss—10 percent of your current weight—can relieve mild
cases of sleep apnea. Other self-help treatments include quitting
smoking and avoiding alcohol and
sleeping pills. Sleeping on your side
rather than on your back also may
help. Some people benefit from a
mechanical device that helps
maintain a regular breathing
pattern by increasing air
pressure through the nasal
passages via a face mask.
For very serious cases,
surgery may be needed.
Menopausal Hormone
Therapy
Until recently, it was
thought that
menopausal hormone
therapy
could ward off
heart disease, osteoporosis,
and cancer,
as well as improve
39
What Else Affects Heart Disease?
40
a woman’s quality of life. But several important studies, conducted
as part of the Women’s Health Initiative, show that long-term
use of hormone therapy poses serious health risks, including
increased risks of heart attack, stroke, and a condition called
venous thrombosis (a blood clot that usually occurs in one of the
deep veins of the leg).
In one study, 16,608 postmenopausal women with a uterus took
either estrogen-plus-progestin therapy or a placebo—a pill that
looks like the real drug but has no biological effect. The results
were surprising: The estrogen-plus-progestin therapy actually
increased women’s risk for heart attacks, stroke, blood clots,
and breast cancer. A related study showed that the hormone
combination doubled the risk of dementia and failed to protect
women from memory loss. However, the estrogen-plus-progestin
medication did reduce the risks of both colorectal cancer and
bone fractures. It also relieved menopausal symptoms such as
hot flashes and night sweats.
The second study involved 10,739 women who had had a
hysterectomy and took either estrogen alone or a placebo. The
results: Estrogen-alone therapy increased the risks for both stroke
and venous thrombosis. The treatment had no effect on heart disease
and colorectal cancer, and an uncertain effect on breast cancer.
Estrogen alone offered no protection
against memory loss.
Estrogen alone, however, did
reduce the risk for bone fractures.
The research also showed
that both estrogen alone and
estrogen combined with progestin
increase the risk of
developing urinary incontinence,
which is the inability to
“hold in” urine. For
Your Guide to a Healthy Heart
women who already have the condition, these medications can
worsen symptoms.
If you are a woman who is taking menopausal hormone therapy,
or if you’ve used it in the past, these findings can’t help but concern
you. It’s important to understand, however, that the results
apply to a very large group of women. For an individual woman,
the increased risk for disease is quite small. For example, in the
estrogen-plus-progestin study, each woman had an increased risk
of breast cancer of less than one-tenth of 1 percent per year.
While questions remain, these findings provide a basis for advice
about using hormone therapy:
■ Estrogen alone, or estrogen-plus-progestin, should not be used
to prevent heart disease. Talk with your doctor about other
ways of preventing heart attack and stroke, including lifestyle
changes and medicines such as cholesterol-lowering statins and
blood pressure drugs.
■ If you are considering using menopausal hormone therapy to
prevent the bone-thinning disease osteoporosis, talk with your
doctor about the possible benefits weighed against your personal
risks for heart attack, stroke, blood clots, and breast cancer.
Ask your doctor about alternative treatments that are safe and
effective in preventing osteoporosis and bone fractures.
■ Do not take menopausal hormone therapy to prevent dementia
or memory loss.
■ If you are considering menopausal hormone therapy to provide
relief from menopausal symptoms such as hot flashes, talk with
your doctor about whether this treatment is right for you. The
studies did not test the short-term risks and benefits of using
hormone therapy for menopausal symptoms. The U.S. Food
and Drug Administration recommends that menopausal
hormone therapy be used at the lowest dose for the shortest
period of time to reach treatment goals.
Remember, your risks for heart disease, stroke, osteoporosis, and
other conditions may change as you age, so review your health
needs regularly with your doctor. New treatments that are safe and
effective may become available. Stay informed.
