• Robert Preidt
• Posted November 30, 2020

Years Leading to Menopause See Uptick in Women's Heart Risks: AHA

Heart disease risk increases in women as they near menopause, so it's crucial to monitor their health and take preventive measures as needed, a new American Heart Association (AHA) scientific statement says.

"Over the past 20 years, our knowledge of how the menopause transition might contribute to cardiovascular disease has been dramatically evolving," Samar El Khoudary, chair of the writing committee, said in an AHA news release. She is an associate professor of epidemiology at the University of Pittsburgh.

"We have accumulated data consistently pointing to the menopause transition as a time of change in cardiovascular health. Importantly, the latest American Heart Association guidelines that are specific to women, which were published in 2011, did not include the data that is now available on menopause as a time of increased risk for women's heart health. As such, there is a compelling need to discuss the implications of this accumulating body of literature on this topic," explained El Khoudary.

Changes in hormones, body composition, cholesterol and blood vessel health as women transition to menopause can increase the risk of developing heart disease after their periods cease, the authors noted.

For many women, menopause begins in their late 40s to mid-50s. Before menopause transition, women produce the female sex hormone estrogen, which may have heart protective effects. During menopause transition, women's ovaries stop producing as much estrogen. This can also occur if a woman has one or both ovaries removed.

There is ongoing research into how hormone therapy might protect against heart disease, and leading medical societies endorse the use of hormone therapy for certain women who've recently started menopause transition.

The AHA statement notes that some common menopause symptoms -- such as hot flashes, night sweats, depression and sleep problems -- have been linked with heart disease.

Also, body changes that occur during menopause, such as increased abdominal fat and fat around organs, are associated with an increased risk of heart disease and cancer death.

Cholesterol levels, vascular vulnerability and metabolic abnormalities appear to increase with menopause beyond the effects of normal aging, according to the statement.

In addition, only about 7% of women transitioning to menopause meet physical activity guidelines, and fewer than 20% consistently eat a healthy diet, the AHA said.

So who is more at risk?

Women who begin menopause at an earlier age have a higher risk of heart disease, and many Hispanic and Black women in the United States experience menopause at younger ages, the AHA said.

The statement emphasizes the importance of monitoring women's health during midlife and viewing this stage as a critical window for applying early intervention strategies, El Khoudary said.

"Thus, health care professionals may consider an aggressive, prevention-based approach for women during this stage in their lives to decrease the probability of a future cardiovascular disease occurrence, such as heart attack or stroke," El Khoudary added.

The statement was published Nov. 30 in the journal Circulation.

More information

For more on menopause, go to the U.S. Office on Women's Health.

SOURCE: American Heart Association, news release, Nov. 30, 2020