Menopause and Cardiovascular Risk

middle-aged doctor counsels patient

Does menopause increase a woman's risk of heart disease and stroke?

A woman’s risk for cardiovascular disease rises as she ages. Some changes in the body are relevant to cardiovascular risk.

Cardiovascular risk factors that every woman should know about include:

  • Age at the time of menopause. Women who reach menopause before age 45 have a significantly higher risk of coronary heart disease. Coronary heart disease results from plaque buildup in the arteries.

  • The cause and timing of menopause. Menopause caused by surgical removal of both ovaries at an early age can lead to a higher risk of cardiovascular disease. But the same surgery around the age of natural menopause does not raise risk. (A hysterectomy doesn't appear to influence cardiovascular risk before or after menopause.)

  • Estrogen. Levels of estrogen, which helps keep blood vessels relaxed and open, start to decline markedly as menopause approaches. With less estrogen, cholesterol may begin to build up on artery walls. A buildup in vessels leading to the heart or brain can increase the risk of heart disease or stroke.

  • Hot flashes and night sweats. Hot flashes and night sweats are the most common menopause-related symptoms and can last up to 10 years. They also are associated with worse cardiovascular disease risk factor levels.

  • Depression and sleep problems. In some studies, depression and sleep disturbances were linked to an increased risk of heart disease.

  • Increased visceral fat. This type of fat, in the abdominal cavity near vital organs, is associated with a higher risk of cardiovascular disease and cancer.

  • Cholesterol levels and metabolic syndrome risk. These cardiovascular risk factors appear to increase with menopause beyond the effects of normal aging. (Metabolic syndrome is diagnosed when a person has three or more of these individual risk factors: abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure and high blood sugar).

Talk to your health care team about your risk factors and how to prevent cardiovascular disease before, during and after menopause.

 
Written by American Heart Association editorial staff and reviewed by science and medicine advisors.

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Last Reviewed: Jul 27, 2021