Nursing Care of the Postmenopausal Woman, 3rd Edition
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be screened yearly. Older adults often have a systolic blood pressure of 130 mm Hg or higher with a diastolic of less than 80 mm Hg. This is due to age-related stiffening of the major arteries and is called isolated systolic hypertension (NIA, 2021). Women over age 70 have a higher risk of high blood pressure than men (AHA, 2021). Individuals with a higher blood pressure should be receiving medical care and a schedule for having their blood pressure checked should be determined with the primary care provider. In some cases, high blood pressure can be controlled with lifestyle changes. If not, medications can assist with lowering the blood pressure. ● Lipid profile : A lipid profile test consists of total cholesterol, high- density lipoproteins, low-density lipoproteins, and triglycerides. If possible, the woman should fast for 8 to 12 hours before having her blood drawn. Fasting prior to this test is preferred; however, a nonfasting test is sufficient for evaluating most cardiovascular risks (Ehrlich, 2021). If the results are normal, the test should be repeated approximately every five years until age 64, and then every three to five years, depending on other risk factors. If an abnormal result is obtained, the woman should be educated in heart-healthy lifestyle modifications and, depending on the provider and the lipid level, the provider may prescribe medication to improve the levels. The American Heart Association (AHA) occasionally reevaluates normal levels for lipids (AHA, 2019).
Starting at age 20, this test should be performed every four to six years unless there are abnormalities, in which case it might be needed more frequently. High cholesterol can often be managed through lifestyle changes or medications (CDC, 2022d). The American Heart Association (AHA) recommends screening for lipids beginning at age 40 years if there is a risk factor for coronary heart disease (AHA, 2019). ● Body weight : The primary care provider will want to know the woman’s weight and height to calculate her body mass index (BMI) during her visit. If she is not at a healthy body weight, she is at higher risk for heart-related problems. BMI should be updated at each healthcare examination. Women who are overweight should be offered referral to behavioral counseling to promote a healthful diet and physical activity. ● Blood glucose : High blood glucose levels put the woman at increased risk for developing insulin resistance, stroke and heart disease. Therefore, the provider may suggest a blood test called glycosylated A1c. This is a more accurate assessment of diabetes risk than a one-time fasting or random glucose level. This test is discussed further below. ● Tobacco use : Ask all women whether they use tobacco and if so, what form. It is also important to ask about vaping. Advise them about stopping and provide them with behavioral interventions and approved prediabetes, or type 2 diabetes. Untreated diabetes can lead to serious medical issues, including
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