Cardiovascular Risks May Be Greater Before Menopause

Brandon May
Published Online: Friday, September 9th, 2016
Past research has shown that conditions such as heart disease, obesity, and diabetes occur more frequently following menopause. However, recent study results suggest the exact opposite.
According to study findings recently published in the Journal of the American Heart Association, women are at greater risk for developing stroke, heart disease, and diabetes prior to the onset of menopausal symptoms.
Menopause is a natural process characterized by the marked and steady decline of female reproductive hormones, namely estrogen and progesterone. This process typically occurs in women between ages 45 and 55 and produces symptoms such as hot flashes, vaginal dryness, night sweats, and sometimes, weight gain.
Menopause is also linked to an increased risk of metabolic syndrome, with obesity being a prime condition related to the disorder. It’s well known that obesity increases the risk of heart disease as well as stroke and diabetes. A history of physical inactivity and smoking may also increase the risk of developing these diseases prior to menopause.
The 10-year study involved 1470 white and African-American women with the aim of evaluating the causes and effects of typical heart disease symptoms. Each participant experienced menopause at some point during the duration of the study.
Researchers took into account the women who used hormone-replacement therapy (HRT) during the study period. Following analysis of the data, they saw greater changes in serum cholesterol, blood glucose, and triglycerides prior to menopause onset. African-American women showed a greater increase in blood pressure after menopause, while white American women saw a noticeable jump in waist circumference.
The researchers are still unsure why they saw a greater cardiovascular risk in premenopausal versus postmenopausal women.
“This may mean that the higher cardiovascular risk seen among postmenopausal women could be related to changes in that time before menopause and less so to the changes after menopause has occurred,” theorized Mark DeBoer, MD, of the University of Virginia School of Medicine.
Dr. DeBoer and his colleagues suggested that clinicians should counsel premenopausal patients on the importance of lifestyle changes for reducing cardiovascular disease risk following menopause. Diet, exercise, smoking cessation, and stress reduction are all important educational facets of an integrated and holistic game plan for heart disease prevention, regardless of age or gender.
Notably, the study didn’t take into account specific HRTs that the women used or the hormonal levels of participants. It’s well known that some treatments for menopause symptoms have been linked to an increased risk of stroke and heart attack, so prescribing clinicians should be aware of the effects of certain HRTs and their patients’ health status and history before prescribing an artificial hormone treatment.
Patient education and cardiovascular screening are integral aspects of heart disease prevention for both genders, and they should be increasingly emphasized to women between ages 45 and 55 during the perimenopausal interval. Still, further research is required to determine more probable causes of heart disease and diabetes among menopausal women.

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