Women's Heart Health Declines Rapidly After Menopause, Study Shows

The odds of developing cardiovascular issues, such as a heart attack or stroke, rise sharply after women go through menopause, according to a new study.

“This study is one of the first that shows you are at a markedly increased risk after menopause and that your risk almost matches that of men for cardiac events,” Ella Ishaaya, MD, an internal medicine physician at Harbor-UCLA Medical Center who led the study, told Health.

Experts said the research, presented April 7 at an American College of Cardiology conference, highlights the need to recognize and understand early signs of cardiovascular problems in this population. Traditionally considered a men’s health issue, heart disease is often still under-treated in women despite being the leading cause of death for both women and men in the United States. 

Below, experts break down the connection between heart health and menopause, how women can protect their hearts, and the warning signs of heart disease.

How Menopause Affects Heart Health

It’s already known that postmenopausal women are more vulnerable to heart conditions because they have lower levels of the hormone estrogen, which keeps “bad” cholesterol in check and performs other functions that protect the heart.

Ishaaya said her team wanted to dig deeper into the heart health risks facing this particular group. 

For their analysis, researchers used data from 579 postmenopausal women who took statins to control their cholesterol. The women had undergone two coronary artery calcium (CAC) screenings at least one year apart. The scans can indicate a person’s heart attack risk by measuring the buildup of plaque—cholesterol and other substances—in the heart’s arteries (the higher the score, the greater the risk).

To compare postmenopausal women’s risk of heart issues to the risk for men, the researchers also scanned men with a similar profile in terms of race, age, statin use, blood pressure, and diabetes status as the women screened.

Researchers then divided the participants into three groups based on their first CAC scan results: one to 99, 100 to 399, and 400 or higher. 

The team found that many participants’ second CAC scores were higher than the first. Between the first and second CAC scan, scores for women with a baseline of one to 99 rose by an average of eight points. Women in the second group saw their average scores shoot up by about 31 points.

Those increases were about double that of their male counterparts.

One of the study’s weaknesses, per Ishaaya, was that the researchers only analyzed data from women taking statins. That many participants’ CAC levels still rose despite the medication suggests the risk may be even greater among postmenopausal women who do not take statins, she added.

How to Protect Heart Health

You should start protecting your heart before you even hit menopause, according to Megan Kamath, MD, a cardiologist at UCLA Health.

“One of the best things that postmenopausal women can do is take a preventative approach in their premenopausal years, which can continue into their postmenopausal years,” she told Health. “Women need to take charge of their cardiovascular health, and this begins early with diet, exercise, and heart-healthy lifestyle modifications.”

Those lifestyle changes include quitting smoking and managing stress through methods such as yoga and meditation, Petra Zubin Maslov, MD, PhD, a cardiologist at Mount Sinai Morningside, told Health.

It’s also important to regularly consult a doctor about your cholesterol, blood pressure, and overall risk for heart disease.

If you do start to notice signs of heart disease, such as a heaviness in the chest, heartburn, chronic fatigue, or pain in the neck, jaw, or back, Zubin Maslov stressed the importance of consulting a medical professional and not chalking the symptoms up to the “normal” effects of aging.

Because some symptoms overlap with other conditions, she recommends seeing a cardiologist if you have health issues that persist despite treatment.

“Heart disease is preventable and treatable,” Reynolds said. “It’s never too late to start taking better care of yourself.”