Women’s heart risk spikes after menopause, study shows

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At first, no one thought Nina White had a heart attack.

Every detail of that day 10 years ago, when she was just 51, is sharp in her memory. She thought the tightness in her chest was overexertion from multiple trips up the ladder to the attic in her Portsmouth home. Her husband thought it was indigestion from tacos.

But her sister, who has a medical technology background, urged her to go to the emergency room and get a blood test that can detect heart attacks for a brief period after they’ve happened. When she got there, even the doctor told her he didn’t think she’d had one.

Then, the test came back positive for troponin, a protein released when the heart is damaged.

“It was horrifying,” White said. “So many people die in the first year after a heart attack, and I was terrified. I was waiting for it to happen.”

Heart disease is the leading killer of women as well as men, but it’s often under-recognized in women, said Dr. Dena Krishnan, White’s cardiologist for the past two years. Krishnan practices at the Bon Secours-affiliated Cardiovascular Specialists clinic in Suffolk.

“What you notice is women tend to have had symptoms for longer,” Krishnan said. “It’s really bad by the time they come to seek help.”

New research may help explain the complex reasons why heart risk increases sharply after menopause. Now, there’s evidence that as their estrogen drops, women’s risk rises faster than that of men the same age. Arterial plaque increased twice as fast on average in postmenopausal women than in men with similar demographics and medical status, according to research presented last month at an American College of Cardiology conference based on a study of 579 postmenopausal women.

Doctors have long known that estrogen seems to provide protection against heart disease. But it’s hard to pinpoint how menopause interacts with other risk factors, like genetics and lifestyle, in part because its onset and length vary so significantly among women.

“What this more recent study was showing is that we have some preventative testing that we can do to look at otherwise low-risk women, say ages 40 to 70, and see, is there anything else they should be doing?” Krishnan said.

White thought she was low risk. Other than her grandmother, whose heart attack the family attributed to smoking, she wasn’t aware of any family history of heart disease. Neither of her two older siblings had been diagnosed with it then.

But White said she had a hysterectomy at age 42 due to severe endometriosis, a painful condition in which uterine tissue grows outside of the uterus. The effect a hysterectomy has on estrogen production depends on what exactly is removed; if the uterus and both ovaries are removed, “surgical menopause” begins immediately. But even if only the uterus is removed and both ovaries remain, research shows that menopause is likely to begin earlier.

“It is very complex, because we know that estrogen impacts so many things,” Krishnan said, mentioning vasodilation, or the widening of the arteries, and preventing insulin resistance, among other benefits. “So, they’re looking at all different reasons you may not have enough estrogen.”

Many women think the obvious solution would be to take estrogen, Krishnan said, but it’s not that simple. Depending on an individual’s medical history, taking estrogen could possibly increase inflammation or blood clots or even contribute to developing cancer.

“That’s what makes it so unique for every woman on how to manage their risk,” Krishnan said.

Women’s symptoms during a heart attack are more likely to include dizziness, fatigue and nausea, but women are also more likely to dismiss chest pain as indigestion or overexertion, Krishnan said.

Almost every woman who has a heart attack tells Krishnan they didn’t realize it was happening. Many have said they just thought their bra was too tight. But if women are feeling pressure or heaviness in their chest during average activities, like cleaning the house, bringing in the groceries or making the bed, that could be cause for concern, she said.

That doesn’t mean exertion should be avoided. Regular exercise is one of the best ways to protect against heart disease, Krishnan said, adding that in animal models, aerobic training has been shown to mitigate the effects of estrogen loss.

“A lot of people think, ‘It’s out of my control. It’s just what it is. Every woman in my family gets diabetes and hypertension.’ And that’s not true,” she said. “Staying physically active is so essentially important.”

Women should ask their primary care doctors about their heart health, Krishnan said, and if they’re having questionable symptoms or if they have a family history, they may need a cardiology appointment.

“You never want to feel like a ticking time bomb, and there’s many people who feel that way,” Krishnan said.

Have a health care or science story, question or concern? Call, text or email Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com

Key results from primaries in Kentucky, Georgia, Oregon and Idaho

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Daniela Altimari | CQ-Roll Call (TNS)

Primaries in Kentucky, Georgia, Oregon and Idaho set matchups Tuesday for November House races and, with many districts heavily favoring one party, effectively chose the next member of Congress. Some races also featured fierce competition to run in races that will be on the November battleground, and one featured possible meddling by the opposing party to get a preferred challenger.

Here’s a rundown of the key results so far. This report will be updated.

Georgia

Ex-Trump aide in runoff for open seat: Brian Jack, who served as White House political director under President Donald Trump, finished first in a five-candidate primary but did not clear the threshold to win the GOP nomination in the open 3rd District.

If no candidate in Georgia gets more than 50% in a primary, the top two finishers meet in a runoff, which this year will be on June 18.

Jack, who had Trump’s endorsement, had 46.7 percent of the vote at 11:13 p.m. Tuesday, when the AP made the call that he would be in the runoff against state Sen. Mike Dugan. Dugan finished second with 25%. The race in November is rated Solid Republican — Trump beat Joe Biden here by 25 percentage points in 2020 — so the winner of the runoff will be a favorite to join the 119th Congress. Four-term incumbent Republican Rep. Drew Ferguson said in December he would not run again.

Kentucky

Massie renominated with ease: Rep. Thomas Massie, who recently was one of the leaders in the failed push by House conservatives to oust Speaker Mike Johnson, R-La., easily dispatched two GOP rivals in Kentucky’s 4th District.

At 7:11 p.m., when The Associated Press called the race, Massie had 75% of the vote. He beat two underfunded Republicans: retired attorney Eric Deters and Michael McGinnis. Two years ago, Massie faced three challengers and won with 75% of the vote.

Outside groups had waded into the race. United Democracy Project, which is affiliated with the American Israel Public Affairs Committee, spent $153,000 on an ad attacking Massie for voting against funding for Israel. The Protect Freedom PAC, which was founded by people who had worked with Sen. Rand Paul, R-Ky., spent $549,000 on ads and direct mail supporting Massie.

Democrats did not run a candidate in the primary.

Idaho

Simpson prevails: Rep. Mike Simpson easily won the nomination to a 14th term, defeating challengers Scott Cleveland and Sean Higgins in the 2nd District Republican primary.

Simpson, who chairs the Interior-Environment Appropriations Subcommittee, had 57% of the vote at 12:10 a.m. Eastern, just after the AP called the race at 12:07 a.m.

Simpson will face Democrat David Roth in a November race rated Solid Republican by Inside Elections.

Oregon

Bynum overcomes mystery PAC spending: Oregon Democrats overwhelmingly selected Janelle Bynum, a legislator from Clackamas County who was supported by many national party leaders, to take on Republican freshman Rep. Lori Chavez-DeRemer.

Bynum defeated progressive attorney Jamie McLeod-Skinner, the party’s 2022 nominee, with 70% of the vote at 11:38 p.m. Eastern on Tuesday when the AP called the race. McLeod-Skinner narrowly lost to Chavez-DeRemer after defeating then-incumbent Rep. Kurt Schrader in the Democratic primary.

The contest between Bynum and Chavez-DeRemer in a battleground district where Biden beat Trump by 9 percentage points in 2020 is expected to be among the nation’s most closely watched races. Inside Elections with Nathan L. Gonzales rates the race a Toss-up.

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Outside money poured into the primary. A super PAC called 314 Action, which supports Democratic scientists running for office, spent $474,000 in support of Bynum, who has a degree in electrical engineering. Mainstream Democrats PAC, which is funded by LinkedIn founder Reid Hoffman, spent more than $750,000 on ads backing Bynum and opposing McLeod-Skinner.

Last week, a super PAC called Health Equity Now, which hasn’t disclosed its donors, although the AP reported it has ties to GOP operatives, dropped $550,000 into the race for ads highlighting McLeod-Skinner’s support for “Medicare for All,” a popular position among progressive voters. Bynum’s supporters said Republicans were trying to meddle because they saw McLeod-Skinner as the weaker candidate to run against Chavez-DeRemer in November.

Chavez-Deremer, who had no primary opponent, approaches the general election with a huge cash advantage. She had $1.9 million in her campaign account on May 1, compared with Bynum’s $340,000.

Dexter wins 3rd District: Physician and state Rep. Maxine Dexter defeated six fellow Democrats, including the sister of Washington Rep. Pramila Jayapal, to win the party’s nomination for an open seat centered in Portland.

Dexter, who had 53.1% of the vote not long after 11:54 p.m. Eastern, when the AP called the race, will face Republican Joanna Harbour in November. But given the 3rd District’s Democratic dominance, she is favored to succeed retiring Democratic Rep. Earl Blumenauer.

“I want to congratulate Representative Maxine Dexter for winning the Democratic primary for Oregon’s Third Congressional District. Maxine has proven herself to be a serious and effective legislator, I am confident she’ll take this success with her to Washington, D.C.,” Blumenauer said in a statement when the race was called.

The race was largely a contest between Dexter, Gresham City Councilor Eddy Morales and former Multnomah County Commissioner Susheela Jayapal, Rep. Pramila Jayapal’s sister.

Super PACs flooded the primary with cash. Dexter has been the beneficiary of more than $2.2 million spent by 314 Action. Meanwhile, Voters for Responsive Government, a super PAC based in Los Angeles, spent more than $2.4 million targeting Jayapal. Much of that money was spent on TV ads blaming her for failing to deal with homelessness in Multnomah County.

DeSpain to face Hoyle: Republican Monique DeSpain, an attorney and retired Air Force colonel, will take on freshman Democratic Rep. Val Hoyle in Oregon’s 4th District, which Biden carried by 13 points in 2020.

DeSpain was running well ahead when the AP called the race at 1:13 a.m. Eastern on Wednesday, defeating fellow Republican Amy Ryan Courser, a former Keizer City Councilor.

While the contest in the southern Willamette Valley is rated Likely Democratic by Inside Elections, Republicans in Washington, D.C., say Hoyle is vulnerable. They are raising allegations of wrongdoing from when she was the head of the Oregon Bureau of Labor and Industries and believe DeSpain will run a strong campaign.

Hoyle, who had no primary challenger, had $619,000 in her campaign account on May 1, while DeSpain had $69,000.

Salinas rematch set: Democratic Rep. Andrea Salinas will defend her 6th District seat in November against businessman Mike Erickson, the Republican she beat in 2022. Salinas defeated veteran Cody Reynolds in the Democratic primary, while Erickson beat three opponents for the Republican nomination. Two years ago, Salinas beat Erickson by 2.5 percentage points.

The race in November is rated Likely Democratic.

Niels Lesniewski contributed to this report.

©2024 CQ-Roll Call, Inc., All Rights Reserved. Visit cqrollcall.com. Distributed by Tribune Content Agency, LLC.

Contemporary Christian star Brandon Lake to play Xcel Energy Center in October

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Contemporary Christian star Brandon Lake has extended his Tear Off the Roof Tour and added an Oct. 13 stop at St. Paul’s Xcel Energy Center.

Tickets go on sale at 10 a.m. June 3 through Ticketmaster. A presale is available to fans who sign up at brandonlake.co/roof. Neither the promoter nor the venue announced ticket prices.

Lake, 33, grew up in South Carolina, where his father was a pastor. He taught himself how to play guitar using YouTube clips and, as a teen, accompanied the worship team at his church.

In 2015, he used GoFundMe to raise $23,000 to record his debut album “Closer,” which he self-released the following year.

He went on to sign a deal with Bethel Music and saw his version of Tasha Cobbs Leonard’s “This Is a Move,” which he co-wrote with her, become his first charting single. It won a 2019 GMA Dove Award and earned a songwriting Grammy nomination.

In the years since, Lake has scored a series of Christian radio hits, including the chart toppers “Gratitude” and “Praise You Anywhere.” He has also won five Grammys for the songs “Kingdom” and “Fear Is Not My Future” and for the albums “Old Church Basement,” “Kingdom Book One Deluxe” and “Breathe.”

In June, Lake will publish the children’s book “Little Lion Lungs,” which he wrote with his wife Brittany.

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Minnesota Legislature: Medical aid in dying bill didn’t cross finish line this session

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Despite advancing through several House committees, Minnesota’s End-of-Life Option Act did not receive a floor vote in the House or Senate during the 2024 legislative session, which ended earlier this week.

The legislation, co-authored by Rep. Andy Smith, DFL-Rochester, and Sen. Liz Boldon, DFL-Rochester, would have permitted medical aid in dying, also known as physician-assisted suicide. The measure would have allowed terminally ill adults to request a prescription for life-ending medication, which they would have to self-administer.

Rep. Mike Freiberg, DFL-Golden Valley, has introduced the End-of-Life Option Act in the Minnesota House several times. This year, the proposal advanced further than it ever had before. The House bill received a pre-session hearing in the House Health Finance and Policy Committee. Testimony for and against the bill ran for more than three hours.

Following the health committee, the bill progressed through the House’s public safety, judiciary and commerce committees.

The bill was not included in the health omnibus bill, which was ultimately passed as part of an even bigger omnibus bill Sunday night.

The End-of-Life Option Act’s companion bill in the Minnesota Senate did not receive any committee hearings in that chamber. In March, Boldon said there was not enough support in the Senate.

“It’s something that I very much hope we can continue talking about because it’s important, but there is a diversity of thought around this within my caucus in the Senate,” Boldon said. “And so I don’t see it having the votes to pass this session.”

Medical aid in dying is available in 10 U.S. states and Washington, D.C.

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