In a recent study published in the Journal of the American Heart Association, researchers discussed the importance of heart health in women going through menopause.


Cardiovascular disease is the leading cause of death in women, especially for women of colour.  A new study outlines how changing hormone levels put menopausal women at risk for cardiac events and highlights the importance of living a healthy lifestyle during midlife to minimize their risk.

Cardiovascular disease (CVD) is a term used for diseases affecting the heart and blood circulatory system.  CVD can lead to serious medical conditions such as a heart attack, heart failure, stroke, peripheral artery disease, or renal disease.

Typical heart attack symptoms include:

  • Pressure and pain in the center of the chest
  • Pain in the jaw, upper neck, and arms
  • Shortness of breath
  • Dizziness, nausea, and/or vomiting
  • Cold and clammy skin, or sweating

Women may experience prodromal symptoms (warning symptoms experienced prior to a cardiac event) such as unusual fatigue, indigestion, chest pressure, and difficulty sleeping up to a year before having a heart attack.  Unfortunately, since these symptoms are vague, they are easy to ignore or misdiagnose.

Risk factors for CVD include a family history of CVD, smoking, obesity, high cholesterol, a sedentary lifestyle, and hypertension. However, the risk factors for women also include pregnancy-induced hypertension, gestational diabetes, and inflammatory diseases such as arthritis.

Menopause is a risk factor for cardiovascular disease

During mid-life, women experience an additional risk factor for CVD: menopause.  Menopause marks the end of menstruation and is accompanied by a decrease in estrogen production.  Since estrogen is heart protective, lower estrogen levels in post-menopausal women adds to their overall heart attack risk.

In a recent study published in the Journal of the American Heart Association, researchers from the University of Michigan found that a healthy lifestyle during the transition to menopause may offset the increased CVD risk caused by lowering estrogen levels.  This study was based on data from women participating in the Study of Women’s Health Across the Nation (SWAN).  Over the course of 10 years, these women (aged 42-52 at the start of the study) were given annual medical exams and questionnaires about their physical activity and smoking and eating habits.  Each woman also underwent a non-invasive, coronary artery ultrasound.

Minimizing heart disease risk with a healthy lifestyle

The research team found that women with healthier lifestyles had significantly wider arteries with less arterial wall thickening or plaque buildup (atherosclerosis).  Women who smoked had the least healthy arteries.  In sum, this study suggests that the best way for women to improve their heart health is to improve their lifestyle. These changes include eating a diet with whole grains, vegetables, fruits, and lean proteins, exercising regularly, getting adequate sleep, finding ways to reduce stress, and quitting smoking.

In a recent press release, Dr. Ana Baylin, MD, one of the authors of the study noted, “Midlife is a crucial window for women to take their cardiovascular wellness to heart and set a course for healthy aging. The metabolic changes that often occur with menopause especially increases in cholesterol levels and blood pressure can significantly increase the risk of heart attacks, strokes and cognitive impairment later in life.”

Written by Debra A. Kellen, PhD


  1. Wang D, Jackson E, Karvonen‐Gutierrez C, Elliott M, Harlow S, Hood M et al. Healthy Lifestyle During the Midlife Is Prospectively Associated With Less Subclinical Carotid Atherosclerosis: The Study of Women’s Health Across the Nation. Journal of the American Heart Association. 2018;7(23).
  2. Got menopause? Healthy lifestyle now is crucial for heart health [Internet]. EurekAlert!. 2019 [cited 23 January 2019]. Available from:
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