Study sheds light on association between menopause and heart health

Heart disease is the leading cause of death in both men and women, but women’s cardiovascular risk has traditionally been undertreated because women tend to develop heart disease at an older age than men and may experience different and sometimes more subtle symptoms. After menopause, women have much less estrogen and shift to a more testosterone-heavy profile. This affects the way the body stores fat, where it stores fat and the way it processes fat; it even affects the way the blood clots. And all of these changes increase the risk of developing heart disease.

In the study, post-menopausal women underwent heart scans to assess their CAC score, indicating plaque buildup in heart arteries. Researchers analyzed data from 579 women on statins, comparing CAC changes with matched men. Women with baseline CAC levels of 1–99 and 100–399 showed significantly higher CAC increases compared to men. No significant difference was observed for baseline CAC levels of 400 or higher.

The findings suggested that plaque buildup is accelerated in post-menopausal women compared to men, indicating that many women experience a steep rise in the risk of heart problems, which may be related to the drop in estrogen that women experience during menopause.

“This is a unique study cohort of only post-menopausal statin users that signals that post-menopausal women may have the risk of heart disease that is on par with males. Women are underscreened and undertreated, especially post-menopausal women, who have a barrage of new risk factors that many are not aware of. This study raises awareness of what those risk factors are and opens the door to indicating the importance of increased screening for coronary artery calcium (CAC),” said Ella Ishaaya, MD, an internal medicine physician at Harbor-UCLA Medical Center in Torrance, California, and the study’s lead author.

Reference: “CAC Progression in Men and Women: Is There an Inflection at Menopause?” AMERICAN COLLEGE OF CARDIOLOGY; MEETING: American College of Cardiology's Annual Scientific Session