Menopause can impact a woman’s heart health

The risk of heart disease increases with age for most people, however, for women that may be even more true. The menopause transition, those years leading up to and through menopause, is a time of increasing heart disease risk, according to an American Heart Association scientific statement published in the flagship journal Circulation in 2020.

“While many people think that breast cancer is the leading killer of women in the U.S., in reality heart disease kills more people than all cancers combined,” said Garima Sharma, M.D., FAHA, a volunteer of the American Heart Association. “One in 39 women in the U.S. dies from breast cancer each year, while 1 in 3 dies from cardiovascular disease. That’s roughly one death each minute—and we know that menopause plays in important role in a woman’s cardiovascular disease risk.”

Sharma notes that women face unique risks related to cardiovascular health at every stage of life, the years before and after menopause are a critical time to be aware of and address the increased risks related to heart disease and stroke.

“Menopause is a natural phase of life for most women in their 40s or 50s, but it’s never too early to start learning about how the significant hormonal and physiological changes impact your heart health even in your younger years. In fact, being heart healthy as you head into menopause may reduce later risks,” said Sharma who is director of women’s cardiovascular health and cardio-obstetrics at Inova Health System in Fairfax, Virginia.

A number of studies presented at the American Heart Association’s scientific meetings or published in the Association’s medical journals note the increased risk of cardiovascular disease and other health complications during various stages of menopause:

• After menopause an estimated 1 in 4 women may develop irregular heart rhythms—known as atrial fibrillation—in their lifetime, with stressful life events and insomnia being major contributing factors, according to one study published in the Journal of the American Heart Association (JAHA).
• Another JAHA study found that obesity significantly increased heart failure risk among women who experienced late menopause—at age 55 or older,
• A study presented at the Association’s 2022 Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference (EPI), found that women who naturally entered menopause by the age of 40 had a 40% increased risk of developing coronary heart disease over their lifetime, compared to women who did not go through early menopause.
• A separate study presented at the 2021 EPI meeting found that women who experience very early menopause were 35% more likely to develop some type of dementia later in life, compared with women who enter menopause around age 50.
• Another 2021 EPI meeting study found that social isolation and loneliness may increase cardiovascular disease risk by 29% in post-menopausal women.

Sharma noted that menopause does not cause cardiovascular disease; however, during the menopausal transition women experience many changes in their bodies, including some that can impact their cardiovascular health:

• Decline in estrogen levels
• Hot flashes and night sweats
• Depression
• Sleep problems
• Increased body fat around the organs
• Increased cholesterol levels
• Stiffening or weakening of the blood vessels

“More women in the U.S. are living longer, and a significant portion of them will spend up to 40% of their lives postmenopausal, so it’s important to monitor a woman’s health and lifestyle and develop intervention strategies to protect heart health,” Sharma said. “Solutions won’t be one-size-fits all. This is an area where there is a big need for personalized, preventive cardiology care for women focused on lowering cardiovascular risk.”