Exercise at Menopause: A Critical Difference

Margaret Burghardt, MD


Medscape General Medicine. 1999;1(3) 

In This Article

The Dangers of Inactivity

Physical inactivity is one of the modifiable risk factors for coronary artery disease (CAD), along with cigarette smoking, increased cholesterol levels, hypertension, obesity, and diabetes mellitus.[35] Physical fitness can be improved at any age, and pre- and postmenopausal females show no difference in their ability to alter body composition and improve cardiorespiratory endurance.[8] While CAD studies are now emerging that include or focus on women, many of the earlier presumptions and recommendations regarding women and heart disease were based on studies that only monitored men. Since the early studies in the 1950s of CAD rates in men in well-defined active or sedentary occupations, the literature has shown a strong inverse relationship between habitual physical activity and CAD.[36] In an 8-year study of men and women, with mean age range between 40 and 50 years, Blair and associates[37] used a defined measure of physical fitness (maximal treadmill exercise test) to serve as an objective marker for self-reported habitual physical activity. All-cause mortality rates declined significantly between the least fit and the most fit individuals of both sexes, and the difference was mainly attributable to decreases in cardiovascular disease (CVD) and cancer in the active group. This held true even when adjustments were made for potential confounding variables (such as age, cholesterol levels, and smoking status). This is valuable information because, to date, physical fitness and CHD in women have not been thoroughly studied. The physical activity questionnaires and exercise programs applied to female populations in CHD studies have often been developed and originally validated on males. These questionnaires may not request information about women's regular physical activities (including activities of daily living) and thus may affect the risk assessment for women in some CHD studies. More research is necessary to accurately define risk factors for CHD in women.