Whether you are a man or a woman, the risk of heart disease increases with age. This is especially true for women. The “menopausal transition” is a period of increased risk of heart disease, as recalled by the American Heart Association in the scientific journal Circulation in 2020.
“In fact, heart disease causes more deaths than all cancers combined,” says Dr. Garima Sharma of the American Heart Association (AHA). “ One in 39 women in the United States die from breast cancer each year, while one in three die from cardiovascular disease. We know that menopause plays an important role in the risk of cardiovascular disease in women. »
In France, cardiovascular diseases still kill 200 women per day, 76,000 women per year. It is the leading cause of death among them.
Risk of heart disease increases as menopause approaches
The peri-menopausal years are particularly critical for recognizing and managing increased risk of heart disease and stroke. “ Good cardiovascular health before entering menopause may reduce later risks reveals Garima Sharma, director of women’s cardiovascular health and cardio-obstetrics at Inova Health System in Fairfax, a large nonprofit health care network based in Virginia, United States.
Numerous studies have highlighted the increased risks of cardiovascular diseases during menopause:
– 1 in 4 postmenopausal women could develop cardiac arrhythmias, such as atrial fibrillation. Stressful life events and insomnia increase this risk;
– obesity considerably increases the risk of heart failure in women who have had late menopause (at age 55 or over);
– women who have experienced early menopause (before age 40) have a 40% increased risk of developing coronary heart disease during their lifetime, according to a study published in 2022;
– social isolation and loneliness can increase the risk of cardiovascular disease in post-menopausal women by 29%, estimates the AHA;
– Recent data show a reversal of associations between HDL cholesterol (“good cholesterol”) and heart disease risk during the menopausal transition, suggesting that high levels of good cholesterol do not always reflect good heart health. Don’t rely on it after menopause!
Risk factors worsen during menopause
Menopause itself does not cause cardiovascular disease. However, during this transition, women experience several changes that can affect their cardiovascular health, including a drop in estrogen levels, an increase in LDL cholesterol (the “bad”) level, a change in the structure of the vessel wall blood in the sense of a hardening or on the contrary a relaxation, but also an increase in triglycerides, uric acid, hemoglobin and liver enzymes.
When estrogen decreases during menopause, cells undergo degradation, which promotes the formation of atherosclerotic plaques. These progressive deposits of lipids develop on the inner wall of the arteries, making them more rigid. Eventually, these plaques can block the artery, leading to a myocardial infarction.
Additionally, physiological changes during menopause, such as an increase in abdominal fat but also visceral fat (around organs), are associated with an increased risk of all-cause mortality, cardiovascular disease and cancer, even in those with normal body mass index levels.
Finally, some of the common symptoms associated with menopause are correlated with cardiovascular disease. Hot flashes and night sweats are associated with higher levels of cardiovascular risk factors. Depression and sleep problems, also linked in some studies to an increased risk of heart disease, are common among women during this time.
To find out more: Acting for the hearts of women
Source: Press release from the American Heart Association (10/16/24); International Menopause Society website; Press release dated 10/18/24 from the National Federation of Colleges of Medical Gynecology; Journal of the American Heart Association; AHA Communications & Media Relations in Dallas: 214-706-1173; S Temamura, T Sankai, K Yamagishi et al. Changes in cardiovascular disease risk factors during menopausal transition in Japanese women: the circulatory risk in communities study (CIRCS). Menopause. 2023, 30; 88-94; Act for the hearts of women.
