About Menopause Heart Disease
Cardiovascular disease encompasses a variety of conditions that affect the heart or blood vessels, including coronary heart disease and stroke, among others.
Prevalence of Menopause Heart Disease
Studies have shown that cardiovascular disease is the main cause of death in postmenopausal women.1 In fact, women are four times more likely to develop heart problems about 10 years after their final periods.2
Interestingly, middle-aged women are oftentimes unaware of cardiovascular risks and point to osteoporosis or breast cancer as their main potential health threats.
What Causes Heart Disease after Menopause
Menopause by itself does not cause heart disease. However, there are several factors that appear during the transition that may put postmenopausal women at a higher risk of developing cardiovascular disease.
Hormones and Menopause Heart Disease
The principal risk factor of menopausal heart problems relates to hormones.
As women enter the transition, estrogen and progesterone production in the ovaries becomes unstable. The erratic hormonal fluctuations that ensue continue during perimenopause. By the time women reach their final periods, estrogen and progesterone levels are at their lowest levels, which will continue throughout postmenopause.
During reproductive years, estrogen exerts protective effects on the cardiovascular system. With estrogen decline and other changes that happen during the transition, those protective effects are lost, and women's heart disease risks go up.
Other Risk Factors of Menopause Heart Disease
While aging itself is linked to an increased risk of cardiovascular disease for both men and women, those risks are even higher for menopausal women due to a number of physiological changes that occur in that life stage:3,4,5,6
Menopausal weight gain. Excess weight is a risk factor for cardiovascular disease for all age groups. Menopausal women are more prone to weight gain, particularly around the waist, further increasing the risk of heart issues.
Hypertension. High blood pressure - another risk factor of cardiovascular disease - is more common in middle-aged women than in men of the same age.
Abnormal lipid levels. The levels of low-density lipoprotein (LDL) and triglycerides tend to increase in menopause, while high-density lipoprotein (HDL) decreases, exposing women to a higher risk of heart problems and blood clots.
Unhealthy habits. Smoking, a diet rich in saturated and trans fats, and a sedentary lifestyle are directly linked to cardiovascular disease. Many of such risks are higher in women than they are in men.
Diabetes. Following menopause, women may experience changes in their blood sugar levels, which - if left uncontrolled - can increase their risk of cardiovascular disease and other complications.
Family history. Having close relatives who suffer from heart disease may further increase women's risk of developing such problems on their own after menopause.
How to Prevent Heart Disease After Menopause
Prevention is the central focus of postmenopause care. Implementing wholesome lifestyle changes early on is one of the best ways to prevent cardiovascular disease throughout postmenopause.
Regular check-ups. Monitoring lipid levels, blood pressure, blood sugar levels, and weight through annual check-ups is an essential part of staying healthy and preventing heart disease during postmenopause.
Exercise. Opting for half an hour a day of moderate exercise, five times a week is an excellent way to decrease the risk of heart problems after menopause, including maintaining a healthy weight and controlling cholesterol.8
Nutrition. A nutritious and balanced menopause diet for heart disease prevention should include ample amounts of unsaturated fats, lean protein, and complex carbs as well as foods rich in phytoestrogens and phytosterols.
Unhealthy habits. Quitting smoking offers far-reaching benefits for menopausal health, not only in terms of heart disease, but also osteoporosis prevention and menopause symptom reduction.
Menopause Heart Disease Treatment
The choice of treatment of heart disease in postmenopause will greatly depend on the type of the condition that was diagnosed, its severity, and other associated risk factors.
Implementing wholesome changes to one's lifestyle will benefit all postmenopausal women, regardless of their health status. They essentially include the aforementioned preventative measures, such eating a heart-healthy diet, staying physically active, maintaining a healthy weight, quitting harmful habits, and reducing stress on a regular basis.
While herbal supplements on their own will not treat heart disease, they can help women better take care of their health after menopause. Phytoestrogenic supplements, such as soy, may help regulate lipid levels, while hormone-regulating supplements, like Macafem, can help ease the negative effects of hormonal lows in postmenopausal women.
Depending on the type of heart disease, women may be prescribed medications to manage it more effectively and prevent further complications.
Data regarding cardioprotective benefits of hormone replacement therapy (HRT) is controversial as they depend on its type, timing, and dosage. Due to strong evidence that it may increase the risk of blood clots and stroke, HRT is not recommended for heart disease prevention. Also, women with existing heart disease are advised against taking HRT as well.9,10
As with medications, women with heart disease after menopause may be recommended various medical procedures or surgeries to manage their condition, prevent serious complications, and prolong their lifespan. Depending on the type of the underlying disease, they may help dissolve blood clots, restore blood flow, and improve heart function, among other benefits.
While heart disease is often thought to affect mostly men, it is the main cause of death among postmenopausal women, far surpassing breast cancer. Studies have shown that increased risks of cardiovascular disease appear about 10 years after women's final periods. Although menopause itself does not cause heart issues, numerous physiological changes that take place during the transition make women more prone to developing them. They include low hormone levels, weight gain, and abnormal lipid levels, among others. The majority of emphasis is placed on preventing menopause heart disease through regular check-ups, proper nutrition, addiction control, and regular exercise. Treatment, however, depends on the type of heart disease and include wholesome lifestyle habits, herbal supplements, medications, and surgery.
- British Heart Foundation. (n.d.). Menopause and heart disease. Retrieved March 25, 2021 from https://www.bhf.org.uk/informationsupport/support/women-with-a-heart-condition/menopause-and-heart-disease
- Franciscan Alliance. (2020). Link Between Menopause and Heart Disease. Retrieved March 25, 2021 from https://www.franciscanhealth.org/community/blog/link-between-menopause-and-heart-disease-in-women
- Geburtshilfe and Frauenheilkunde. (2012). Impact of Phytoestrogens on Serum Lipids in Postmenopausal Women. Retrieved March 25, 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168319/
- International Journal of Endocrinology. (2014). Coronary Heart Disease in Postmenopausal Women with Type II Diabetes Mellitus and the Impact of Estrogen Replacement Therapy: A Narrative Review. Retrieved March 25, 2021 from https://www.hindawi.com/journals/ije/2014/413920/
- Johns Hopkins Medicine. (n.d.). Menopause and the Cardiovascular System. Retrieved March 25, 2021 from https://www.hopkinsmedicine.org/health/conditions-and-diseases/menopause-and-the-cardiovascular-system
- Mayo Clinic. (2020). Diabetes and menopause: A twin challenge. Retrieved March 25, 2021 from https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes/art-20044312
- Mayo Clinic. (2020). Menopause hormone therapy and your heart. Retrieved March 25, 2021 from https://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-replacement-therapy/art-20047550
- Oregon State University. (2017). Phytosterols. Retrieved March 25, 2021 from https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/phytosterols
- Penn Medicine. (2016). How to Reduce Heart Disease Risk During Menopause. Retrieved March 25, 2021 from https://www.pennmedicine.org/updates/blogs/heart-and-vascular-blog/2016/march/reduce-heart-disease-risk-factors-during-menopause
- Revista Española de Cardiología. (2006). Menopausal Hormone Therapy and Cardiovascular Disease. Retrieved March 25, 2021 from https://www.revespcardiol.org/en-menopausal-hormone-therapy-cardiovascular-disease-articulo-13094381
- The North American Menopause Society. (n.d.). Keeping Your Heart Healthy at Menopause. Retrieved March 25, 2021 from https://www.menopause.org/for-women/menopauseflashes/bone-health-and-heart-health/keeping-your-heart-healthy-at-menopause
- Clinical Lipidology. (2017). Endogenous sex hormones are associated with blood pressure change and hypertension incidence in postmenopausal women. Retrieved March 25, 2021 from https://www.tandfonline.com/doi/pdf/10.2217/clp.12.73
- American Heart Association. (2015). Menopause and Heart Disease. Retrieved March 25, 2021 from https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/menopause-and-heart-disease
- Circulation. (2020). Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement from the American Heart Association. Retrieved March 25, 2021 from https://www.ahajournals.org/doi/10.1161/CIR.0000000000000912
- Cleveland Clinic. (2019). Estrogen & Hormones. Retrieved March 25, 2021 from https://my.clevelandclinic.org/health/articles/16979-estrogen--hormones
- Climacteric. (2007). Menopause and cardiovascular disease: the evidence. Retrieved March 25, 2021 from https://pubmed.ncbi.nlm.nih.gov/17364594/
- Biochemistry Research International. (2017). Elevated Cardiovascular Risks among Postmenopausal Women: A Community Based Case Control Study from Nepal. Retrieved March 25, 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433412/
- The Lancet. (2019). Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient date. Retrieved March 25, 2021 from https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30155-0/fulltext
- American Heart Association. (2018). American Heart Association Recommendations for Physical Activity in Adults and Kids. Retrieved March 25, 2021 from https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
- The American College of Obstetricians and Gynecologists. (2020). Hormone Therapy and Heart Disease. Retrieved March 25, 2021 from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/06/hormone-therapy-and-heart-disease
- The Lancet. (2019). Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. Retrieved March 25, 2021 from https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31709-X/fulltext