When you’re worried about your health, your heart is probably not at the top of your list—but it should be! More women die from heart disease and stroke than all cancers combined. It’s the leading killer of women, and your risk of heart disease spikes in midlife and menopause. But the good news is that it’s highly preventable, and you can significantly reduce your risk of having a heart attack or stroke. But don’t wait.
“If you ask the average 40-year-old woman what her biggest health concern is, she’s likely to say breast cancer,” says Sarah Speck, MD, one of Seattle’s leading cardiologists and co-founder of POTENTRx, a medical fitness facility that combines medicine, exercise, nutrition, and lifestyle coaching. “Yes, you should get your annual mammograms and pap tests, but you also need to be aware of the risk factors for heart disease because it’s more likely to kill you.”
Why Heart Disease Increases With Menopause
Heart disease occurs when the lining of blood vessels becomes inflamed. Once inflammation starts, the environment is set for cholesterol-related plaque to form in blood vessels. Heart disease isn’t much of a concern during the first half of your life, thanks to estrogen. The anti-inflammatory properties of estrogen help to keep women’s blood vessels flexible, reduce plaque, increase good HDL cholesterol, and keep bad LDL cholesterol in check.
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A lack of estrogen is one of the reasons that men are nearly twice as likely to have heart disease as women early in life. At age 45, one in five men has heart disease compared to only one in nine women. As estrogen levels fall during perimenopause and into menopause, women lose estrogen’s heart protective benefits and, by age 65, their risk for heart disease is similar to men’s risk—one in three.
But you don’t have to become one of those statistics. “There’s an incredible window there—20 years—where you can do something if you realize that you’re at risk,” says Dr. Speck. Think of your hot flashes and other perimenopause symptoms like warning lights on your car. You wouldn’t ignore them and keep driving, would you? Probably not. More likely, you’d check your owner’s manual to find out what they mean. Consider this guide to be your owner’s manual for heart disease. If you take the time to discover what warning lights (or risk factors) you may have, you can take steps to reverse them and reduce your risk of having a heart attack or stroke.