Preventing Heart Disease in Menopause: The Importance of Lifestyle Changes

Hot flashes and night sweats – they are the hallmark symptoms of menopause.

But there’s something else happening to women entering their late 40s and early 50s that they can’t see or feel and may not even know about: Their cardiovascular disease risks are rising.

“As women transition through menopause, they experience a lot of changes,” said Samar El Khoudary, a professor of epidemiology at the University of Pittsburgh’s School of Public Health.

They produce less estrogen. They accumulate more belly fat. Excess abdominal fat is part of a cluster of symptoms that becomes more common after menopause. Known as metabolic syndrome, it is when a person has at least three of the following: abdominal obesity; high triglycerides; low “good” HDL cholesterol; high blood pressure or high blood sugar.

And, “their arteries become more vulnerable to disease, getting thicker and stiffer,” said El Khoudary, who chaired the writing committee for a 2020 American Heart Association scientific statement on how the menopause transition affects cardiovascular disease risk. “All of those changes accelerate during menopause.”

Heart disease is the leading cause of death for women in the U.S., who typically develop the condition several years later than men. But women are largely unaware of their risk for heart disease, which is more likely to kill them than all forms of cancer combined. According to the most recent AHA survey, awareness that heart disease is the leading cause of death among women actually fell between 2009 and 2019, particularly among Black, Hispanic and younger women, for whom primary prevention may be most effective.

The decrease in awareness came as knowledge about women’s cardiovascular risks increased, El Khoudary said. “Over the last two decades, we’ve learned a lot about how menopause contributes to heart health,” she said.

For example, menopause-related hot flashes and night sweats have been linked to a greater risk for high blood pressure and other cardiovascular risk factors. Research also shows depression during the menopause transition is strongly linked to higher cardiovascular disease risk.

Here are 10 points women can follow to improve their heart health during menopause:

  1. Quit smoking or avoid starting if you haven’t already.
  2. Exercise regularly, aiming for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week.
  3. Eat a healthy diet that is low in saturated and trans fats, cholesterol, and sodium, and high in fruits, vegetables, whole grains, and lean proteins.
  4. Maintain a healthy weight and body mass index (BMI).
  5. Monitor and control your blood pressure, cholesterol, and blood sugar levels.
  6. Manage stress through relaxation techniques such as deep breathing, yoga, or meditation.
  7. Get enough quality sleep every night, aiming for 7-8 hours.
  8. Limit alcohol intake to no more than one drink per day.
  9. Consider hormone replacement therapy (HRT) if you are experiencing severe menopause symptoms, as it may help improve some cardiovascular risk factors.
  10. Regularly visit your healthcare provider and discuss any concerns or questions about your heart health and menopause.

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