When menopause arrives, many women brace for the hot flashes and mood swings — but few realize that the changes happening under the surface can be even more serious. Cardiovascular disease (CVD) is the leading cause of death for women, and postmenopausal women are particularly vulnerable. Here’s why — and what you can do to protect your heart.
Why Menopause Increases Heart Risk
As estrogen levels drop, several changes can negatively impact cardiovascular health. According to the American Heart Association, this includes:
- An increase in LDL (bad cholesterol)
- A decrease in HDL (good cholesterol)
- Increased blood pressure
- Weight gain around the abdomen
- Changes in blood vessels that make them less flexible (source)
Practical Steps to Protect Your Heart
1. Stay Active
Regular exercise helps manage weight, lower blood pressure, and improve cholesterol levels. To lower your cardiovascular risks after menopause, aim for at least 150 minutes of moderate-intensity aerobic activity each week. Walking, swimming, or cycling all count.
2. Eat a Heart-Healthy Diet
Focus on a Mediterranean-style diet: lots of leafy greens, fruits, whole grains, lean protein, and healthy fats like olive oil and avocados. Limit red meat, processed foods, and added sugars.
3. Monitor Your Numbers
Get regular screenings for cholesterol, blood pressure, and blood sugar. Your doctor may also recommend a coronary calcium score test if you have additional risk factors.
4. Manage Stress
Chronic stress can increase heart disease risk. Practice deep breathing, yoga, or meditation. Apps like Calm or Headspace can help create a daily stress-busting routine.
5. Sleep Well
Lack of sleep is linked to high blood pressure and heart disease. Aim for 7–8 hours of quality sleep. If you struggle with insomnia (common in menopause), talk to your doctor or try relaxation techniques before bed.
6. Limit Alcohol and Quit Smoking
Both habits significantly raise heart disease risk. If you drink, limit yourself to one glass of wine or less per day. And if you smoke, seek help — there are more resources than ever to quit.
7. Ask About Hormone Therapy
Hormone replacement therapy (HRT) isn’t for everyone. However, for some women it may offer heart-health benefits if started around menopause. Discuss the risks and benefits with your doctor.
Essential Heart Health Tests for Women Over 50
1. Blood Pressure Check
Frequency: At least annually, or more often if elevated. Why: High blood pressure is a major risk factor for heart disease.
2. Lipid Panel (Cholesterol Test)
Frequency: Every 4–6 years if levels are normal, annually if borderline or high. Why: Monitors LDL (bad cholesterol), HDL (good cholesterol), triglycerides, and total cholesterol.
3. Blood Glucose or A1C Test
Frequency: Annually or as recommended. Why: Detects diabetes or prediabetes, both of which increase heart disease risk.
4. Coronary Calcium Score (CT Scan)
Frequency: Once after age 50 if you have additional risk factors. Why: Measures calcium deposits in coronary arteries, predicting heart disease risk.
5. High-Sensitivity C-Reactive Protein (hs-CRP) Test
Frequency: As recommended by your doctor. Why: Detects inflammation that can signal higher heart disease risk.
6. Electrocardiogram (EKG/ECG)
Frequency: As needed if symptoms (like chest discomfort or palpitations) occur. Why: Detects heart rhythm problems and signs of previous silent heart attacks.
7. Echocardiogram
Frequency: If recommended due to symptoms. Why: Assesses heart structure and pumping efficiency.
8. Body Mass Index (BMI) and Waist Circumference
Frequency: Annually. Why: Central fat around the abdomen increases heart risk. Aim for a waist measurement under 35 inches.
9. Stress Test
Frequency: If risk factors or symptoms are present. Why: Measures how well your heart handles exertion and can reveal hidden problems.
Bottom Line
Menopause marks a major shift in heart health, but it doesn’t have to be scary. By staying active, eating smart, monitoring key health metrics, and making heart-friendly lifestyle choices, you can lower your cardiovascular risks after menopause. Protect your heart for the long haul, stay informed, be proactive, and remember — your heart health is in your hands.
For more information, visit the American Heart Association.
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