- Past studies have shown that menopause can raise a woman’s risk for several health conditions, including sleep disorders and heart disease.
- A new study found that only about one in five menopausal women have ideal scores on the American Heart Association’s health-assessment tool Life’s Essential 8 (LE8).
- Scientists also discovered that of the LE8’s components, four of them were the most important factors for driving future cardiovascular health risks.
Almost all cisgender women between the ages of
Researchers estimate that more than 1 billion women globally will be in menopause in 2025.
Past studies have shown that menopause can raise a woman’s risk for several health conditions, including
“In the late 40s, around the time of the menopause transition, women undergo many significant changes in their cardiovascular health,” Samar R. El Khoudary, PhD, MPH, professor of epidemiology at the University of Pittsburgh School of Public Health, told Medical News Today.
Changes that happen during menopause“There’s an increase in visceral fat, which we know has implications for heart health. There is an increase in risk of metabolic syndrome, which is a combination of three out of five factors including waist circumference, glucose, triglycerides, HDL (high-density lipoprotein cholesterol), and blood pressure. There’s a change in vascular health, with increasing thickness and stiffness in the carotid artery. And with the symptoms of menopause, sleep can suffer, as well.”
— Samar R. El Khoudary, PhD, MPH
El Khoudary is the senior author of a new study recently published in the journal Menopause that found that about one in five menopausal women have ideal scores on the American Heart Association’s health-assessment tool
Scientists also discovered that of the LE8’s components, four of them — blood glucose, blood pressure, sleep quality, and nicotine use — were the most important factors for driving future cardiovascular health risks.
For this study, researchers analyzed health data from about 3,000 women who participated in the Study of Women’s Health Across the Nation (SWAN), which is an ongoing study of midlife women that started in 1996.
Scientists examined study participant LE8 scores at baseline, around age 46, and into the future. The LE8 includes eight specific health behaviors and factors to help determine a person’s heart health:
- Be more active
- Control cholesterol
- Eat better
- Get healthy sleep
- Manage blood pressure
- Manage blood sugar
- Manage weight
- Quit tobacco
“The eight components identified by the American Heart Association as being linked to cardiovascular disease risk are already well established,” El Khoudary explained. “What remains unclear, however, is how well women in midlife are doing in relation to these components.”
“Our previous work has revealed that the menopause transition is really a critical turning point, a time when women experience changes in many components of Life’s Essential 8,” she continued. “So, women really need to work to counteract all of those changes in midlife to protect their cardiovascular health in the ensuing years.”
At the end of the study, El Khoudary and her team found that four LE8 components — managing blood sugar and blood pressure, sleep quality, and nicotine use — were the main factors driving study participants’ future heart disease risk.
“This finding is important because it highlights key areas … that may have the greatest impact on future heart health for women,” El Khoudary explained. “However, our study did not test whether targeting these specifically leads to better outcomes than focusing on other factors. This is an important question for future clinical trials to explore.”
Researchers also discovered that only one in five menopausal women have an ideal LE8 score.
“When we compare this to the general population, the prevalence is very close,” El Khoudary said. “There’s very low prevalence of optimal LE8 scores. Unfortunately, many people still need to do more, including women who are in this vulnerable stage, the menopause transition. Of course, that’s easier said than done! There are many barriers to living up to Life’s Essential 8. And there is also a lack of awareness. We need to continue to work to address both of those challenges.”
“Next, we need to understand why many midlife women struggle to maintain ideal heart Health and what barriers they face. Research should focus on testing interventions targeting glucose, blood pressure, nicotine use, and sleep to reduce long-term risk. Improving sleep quality also deserves more attention. Ultimately, finding effective ways to help women adopt and stick to Healthy habits is key.”
— Samar R. El Khoudary, PhD, MPH
MNT spoke with Cheng-Han Chen, MD, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, about this study.
“This study examined various health measures and outcomes in midlife women, and found associations between multiple parameters such as blood sugar control, blood pressure, smoking, and sleep quality, and the future risk of developing cardiovascular disease,” Chen said. “These results reinforce the importance of risk factor management in preventing future cardiovascular events for not only perimenopausal women, but across all demographics.”
“As heart disease remains the leading cause of death in women, identifying and controlling the risk factors during menopause for future cardiovascular events can have a tremendous impact on their Health in the following years,” he continued.
“Future efforts in this area should focus on increasing public health awareness and public policy towards promoting heart-healthy habits in perimenopausal women,” he added.
MNT also spoke with Nissi Suppogu, MD, a board certified cardiologist and Medical Director of the Women’s Heart Center at MemorialCare Heart & Vascular Institute at Long Beach Medical Center in Long Beach, CA, about this research to find out why menopause might negatively impact a woman’s heart health.
“The declining estrogen production from the
ovaries is the beginning of all physiological changes at a cellular level. There is less availability of nitric oxide production, increase in inflammation, and changes in stiffness and tone of the vascular smooth muscles. This in turn leads to an increase in blood pressure, an increase in bad cholesterol going up and good cholesterol levels going down, weight gain, depression and stress, hot flashes, and sleep disturbances which in turn affect heart health in these women.”
— Nissi Suppogu, MD
“I think it is fair to say that we now understand that lower estrogen levels around menopause play an important role in cardiovascular health outcomes,” she continued. “Having established this connection, it is imperative to understand when and how we can alter the trajectory for better outcomes.”
“We already know that it is not enough to just replace hormones, it most certainly helps in some women when it’s done at the right time, but it is not enough. That’s why it makes it so crucial to find other interventions and treatments that can work in this pre, perimenopausal environment,” she said.
Suppogu said that this link between LH8 scores’ impact on cardiovascular health and sleep could spark further research into sleep interventions, and how changes in LH8 score may affect heart health.
“Because treating sleep would not just mean just sleep — but goes along with what is actually causing sleep issues in peri/menopausal women along with management of hot flashes, depression, decreased physical activity, and so on that tend to affect ability to fall asleep or stay asleep for longer periods of time,” she added.
