Menopause causes steep rise in heart disease risk, study finds
Danger for women accelerates with hormone changes, researchers said.
Women’s risk of suffering heart attacks and strokes increases rapidly after the menopause and catches up with that of men, research suggests.
The female sex hormone oestrogen has a protective effect on the heart, meaning that younger women are at lower risk of heart disease than men. Heart attacks are often perceived as a male condition.
During menopause, which typically occurs between the age of 45 and 55, the ovaries stop producing as much oestrogen, which causes periods to stop and other changes.
A new study, presented at an American College of Cardiology conference, found that this drop in oestrogen means women’s heart disease risk accelerates and quickly becomes comparable to that of men of the same age. Oestrogen helps to control cholesterol levels and reduces the risk of fat building up in the arteries.
They said doctors should be more proactive in screening postmenopausal women for heart problems and ensure that older women are not being “under-treated”.
They looked at 579 women who had been through the menopause and were being treated with statins to lower their cholesterol, and were matched with 579 men of the same age and health. The participants had two scans, a year apart, to assess the levels of plaque in their arteries, called coronary artery calcium (CAC). This is a key marker of heart disease, which is when arteries become clogged with fatty substances which can cause heart attacks and strokes.
Over the year-long period, the plaque was found to accumulate in the arteries of postmenopausal women twice as quickly as it did in men.
The study’s lead author, Dr Ella Ishaaya, from Harbor-UCLA Medical Center in California, said: “This is a unique study cohort of only postmenopausal statin users that signals that postmenopausal women may have risk of heart disease that is on par with males. Women are under-screened and under-treated, especially postmenopausal women, who have a barrage of new risk factors that many are not aware of.
“After menopause, women have much less oestrogen and shift to a more testosterone-heavy profile. This affects the way your body stores fat, where it stores fat and the way it processes fat; it even affects the way your blood clots. And all of those [changes] increase your risk for developing heart disease.”
Researchers called for greater awareness among doctors of the importance of menopause in increasing heart disease risk among women. Professor Vijay Kunadian, of the British Heart Foundation, said: “The menopause can cause changes to a woman’s body that increase the risk of developing cardiovascular disease, such as high blood pressure, high cholesterol and an increase in abdominal fat storage, often through no fault of the woman herself.
“This study emphasises that statins alone are not enough to help reduce a woman’s risk of cardiovascular disease. We need to equip women with the tools and knowledge to take charge of their own health and ask doctors for help to protect them from future heart problems.”
Heart disease causes one in four deaths in the UK. There are about 2.3 million people in the UK with heart disease — 1.5 million men and 830,000 women. Studies have shown how the perception that heart disease is a male problem is leading to worse heart care for women, who are more likely to be misdiagnosed and dismissed as having indigestion or a “funny turn”. This means they are less likely to get lifesaving treatment for heart attacks.
Previous research has shown that the protective effect of oestrogen means women tend to develop heart disease later than men, and their risk of heart attacks increases drastically after the menopause.
Some studies have suggested that hormone replacement therapy designed to help with menopause symptoms can help reduce the risk of heart attacks and heart disease, as this replaces falling oestrogen levels.
The Times
