Heart Disease and Menopause

“For women, age becomes a risk factor at 55. After menopause, women are more apt to get heart disease, in part because their body’s production of estrogen drops”.¹

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Heart Disease

What is heart disease?

DotS the definition of heart disease may vary. The (United States) Centers for Disease Control and Prevention’s definition is:

“The term “heart disease” refers to several types of heart conditions. The most common type of heart disease in the United States is coronary artery disease (CAD), which affects the blood flow to the heart. Decreased blood flow can cause a heart attack”.²

Before Menopause

Is there an association between before menopause and heart disease?

In Risk Factors: Cardiovascular Risk Factors: Other Common Non-Modifiable Risk Factors Include – Gender the World Heart Federation elaborate on:

“Gender: Your gender is significant: as a man you are at greater risk of heart disease than a pre-menopausal woman. But once past the menopause, a woman’s risk is similar to a man’s”.³

In Health After Menopause: Cardiovascular Disease the (Australian) Jean Hailes for Women’s Health (JH) explain:

“Before menopause, women have a lower risk of heart disease than men, but as women age and their oestrogen levels fall after menopause, their risk of cardiovascular disease increases”.⁴

In Menopause and Heart Disease the British Heart Foundation (BHF) note:

“Before the menopause, women in general have a lower risk of being affected by coronary heart disease. But after the menopause, your risk increases”.⁵

Postmenopause

Is there an association between postmenopause or after menopause and heart disease?

In Lower Heart Disease Risk: What Are the Risk Factors for Heart Disease? the (United States) National Institute of Heart, Lung, and Blood Institute (NHLBI) elaborate on:

“For women, age becomes a risk factor at 55. After menopause, women are more apt to get heart disease, in part because their body’s production of estrogen drops”.⁶

In Menopause and Heart Disease: Estrogen Levels May Play A Role the American Heart Association (AHA) explain:

“A decline in the natural hormone estrogen may be a factor in heart disease increase among post-menopausal women. Estrogen is believed to have a positive effect on the inner layer of artery wall, helping to keep blood vessels flexible. That means they can relax and expand to accommodate blood flow”.⁷

Postmenopause, what other changes may contribute to an increased risk for heart disease?

In Menopause and Heart Disease: Estrogen Levels May Play A Role the AHA also explain:

“Assorted changes in the body occur with menopause. Blood pressure starts to go up. LDL cholesterol, or “bad” cholesterol, tends to increase while HDL, or “good” cholesterol declines or remains the same. Triglycerides, certain types of fats in the blood, also increase”.⁸

The JH also note:

“Blood pressure can increase after menopause, as can total cholesterol and LDL, or ‘bad cholesterol’. There can also be a decrease in HDL, or ‘good cholesterol’. Other blood fats such as triglycerides can also increase”.⁹

Early Menopause

Is there an association between early menopause and heart disease?

Yes. According to the NHLBI:

“Women who have gone through early menopause, either naturally or because they have had a hysterectomy, are twice as likely to develop heart disease as women of the same age who have not yet gone through menopause. Another reason for the increasing risk is that middle age is a time when women tend to develop risk factors for heart disease”.¹⁰

Hormone Therapy Risk

Can choosing to use HT or HRT increase the risk of heart disease?

In Menopause and Heart Disease: Does Hormone Replacement Therapy (HRT) Affect Your Risk of Heart and Circulatory Disease? the BHF also note:

Health Care Provider

What if I think I have heart disease or I have a family history of heart disease?

If you think you have heart disease or you have a family history of heart disease, it may be in your best interest to choose to talk to your health care provider about this.

In Heart Disease: It’s Not Just for Men – You and Your Doctor: A Heart Healthy Partnership the NHLBI also remind us:

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Topic Last Updated: 18 February 2020 – Topic Last Reviewed: 31 January 2020