• Posted April 2, 2024

Women's Heart Risks Rise Sharply After Menopause

Menopause may cause a big shift in plaque buildup in women's arteries, quickly bringing their heart risk to levels that equal men's, a new study finds.

“After menopause, women have much less estrogen and shift to a more testosterone-heavy profile,” explained study lead author Dr. Ella Ishaaya. “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.”

Ishaaya is an internal medicine physician at Harbor-UCLA Medical Center in Torrance, Calif. Her team is slated to present their findings Sunday at the annual meeting of the American College of Cardiology (ACC) in Atlanta.

In the new study, Ishaaya's group tracked outcomes for 579 postmenopausal women who'd already been placed on statins to help control their cholesterol.

They were also given what's known as coronary artery calcium (CAC) scans, which measure the buildup of fats, calcium and other heart disease-related substances in the heart's arteries. Two CAC scans were conducted for each woman, spaced one year apart.

The higher a person's CAC score, the higher their risk for heart attacks or other cardiac events, the researchers explained.

In this study, Ishaaya's team divided the women into three groups based on their CAC scores: 1–99, 100–399 and 400 or higher.

The research showed that, following menopause, women's CAC scores rise much faster than those seen in men of similar age.

For example, women who placed in the lowest level of CAC score at the beginning of the study saw their average scores jump by 8 points, on average, during the one-year study period. That's double the 4-point rise observed in men.

Women in the medium-score level at the start of the study had an average rise of 31 points -- again, almost double the 16 point rise seen among men.

There was no significant difference in the point rise between women and men when it came to folks who already had high CAC scores to begin with, the researchers noted.

All of this means that postmenopausal women appear vulnerable to a faster rise in arterial plaques compared to men.

Why might the be? According to to Ishaaya, estrogen is known to be heart-healthy, so any decline in the hormone is bound to have a deleterious effect.

It's interesting that an uptick in arterial plaque happened even though the women were taking cholesterol-lowering statins, she added. That may mean higher doses of statins are required in postmenopausal women.

“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,” Ishaaya said in an ACC news release.

“Women are under-screened and under-treated, especially post-menopausal women, who have a barrage of new risk factors that many are not aware of," she added. "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).”

Because these findings were presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.

More information

Find out more about the effects of menopause on the heart at Johns Hopkins Medicine.

SOURCE: American College of Cardiology, news release, April 2, 2024