The Role of Physical Activity on Cardiovascular Disease Risk Factors in Postmenopausal Women

Cardiovascular disease (CVD) is the leading cause of death among women in the US. CVD is still thought to be a "man's disease" and remains underappreciated by the public and under treated by health-care providers. Yet, unlike men, a large proportion of deaths attributable to CVD occur in asymptomatic women, making early detection and diagnosis difficult. Therefore, both the development of primary CVD prevention strategies to decrease the risk of CVD and screening tools that will aid in the early detection of women who are at increased risk for CVD has major public health implications. Hormone therapy (HT) has been shown to beneficially affect adverse changes to CVD risk factors that occur during menopause; however, HT is no longer indicated for general CVD prevention. Increased physical activity (PA) levels, either separately or as part of a lifestyle intervention, may decrease CVD risk in women; however, previous reports have not adequately accounted for concurrent changes in HT status.Strategies for primary CVD prevention and early detection in postmenopausal women were examined using 508 women from the Woman on the Move through Activity and Nutrition (WOMAN) study. At baseline, PA was found to be related to more favorable lipid and lipoprotein subclass levels; however, some of these associations were influenced by current HT use. Results at 18 months suggested that a lifestyle intervention was effective for general CVD risk factor reduction regardless of HT continuation or discontinuation. Additionally, lifestyle appeared to attenuate increases in lipid levels that resulted from discontinuing HT. Finally, a simple walking endurance test may provide supplemental information when ascertaining CVD risk in women. In the post-WHI era, concern and confusion about the risks associated with HT has left women and health-care providers searching for alternative means to decrease risk of CVD. Findings from the current report suggest that a non-pharmacological approach for CVD risk factor reduction is both safe and effective for primary CVD prevention in postmenopausal women. In light of the current controversies surrounding the use of HT, the promotion of healthy lifestyle behaviors for CVD risk factor reduction has important public health implications