Menopause and Heart Disease—What’s the Link?

Since cardiovascular disease is the leading cause of death among postmenopausal women, that’s a big problem.¹ In fact, after menopause, 70 percent of women will develop some form of heart disease that increases their odds of having a heart attack or stroke.² And women who experience early menopause (age 45 and under) are at even greater risk of two specific forms of cardiovascular disease— heart failure and atrial fibrillation.³

The Estrogen Connection

Menopause itself doesn’t cause heart disease. But the drop in estrogen that occurs during the menopausal process can significantly impact cardiovascular risk factors. That’s because estrogen helps to keep your blood pressure down by allowing your arteries to widen so that blood can flow through them more easily.⁴ But when estrogen declines during menopause, blood pressure rises, often to unhealthy levels.⁵

Estrogen also helps keep your LDL (bad) cholesterol levels in check.⁶  With less estrogen, studies show that cholesterol levels, as well as triglycerides, become elevated. LDL cholesterol, along with other substances like calcium and cellular waste, makes up the plaque that can build up in arteries, causing them to narrow and stiffen. Triglycerides are a type of fat that, when elevated, can contribute to a hardening of the arteries—a condition known as atherosclerosis.

A study that appeared in the journal Menopause found that total cholesterol, LDL cholesterol, and triglycerides were much higher in postmenopausal women, compared with peri-menopausal women. What’s more, there was also a decline in HDL (good) cholesterol.⁷

Lower estrogen, as well as progesterone, has also been linked to an increase in blood sugar. Over time, this can raise the risk of developing type 2 diabetes. Higher blood sugar levels also set the stage for the weight gain that often occurs during the transition to menopause.⁸ Both of these outcomes significantly increase a postmenopausal woman’s odds for developing heart disease.⁹

But it’s not just the drop in reproductive hormones that impacts your risk of cardiovascular disease. It’s also about the severity of your menopausal symptoms. Research in the American Journal of Obstetrics and Gynecology reports that women who experience severe hot flashes and night sweats during menopause may have an even higher cardiovascular risk.¹⁰

Risk Factors You Need to Watch Out For

According to the FDA, 9 out of 10 women have at least one of the following risk factors for heart disease and that’s especially true if you’re in menopause.¹¹

• Elevated blood sugar or diabetes
• Family history of premature heart disease
• High blood pressure
• High cholesterol
• Overweight or obesity
• Smoking

Many of these risk factors can be improved by simple lifestyle changes, but it’s important to know where you stand so you can take action as needed.

How To Protect Against Heart Disease

Here are six lifestyle changes you can make to reduce your risk of cardiovascular disease. As a bonus, they may even help to reduce the symptoms of menopause.

1. Make heart-healthy food choices. Fresh fruits and vegetables, lean meats, and whole grains, like those featured in the Mediterranean diet, support healthy arteries and overall cardiovascular health. That’s because these foods contain high amounts of bioactive compounds like unsaturated fatty acids, polyphenols, fiber, phytosterols, vitamins, and minerals which exert antioxidant, anti-inflammatory, and antithrombotic effects that can benefit your cardiovascular system.¹²
2. Shake your salt habit. Consuming high amounts of sodium can increase your risk of high blood pressure. However, according to new findings in the Journal of the American Medical Association, eating a low-sodium diet (like the DASH diet) for just one week can reduce your systolic blood pressure by an average of 8 mmHg.¹³ The best way to slash your salt intake? Avoid ultra-processed and fast food, which is typically high in sodium. Instead, prepare more meals at home, using alternatives to replace or reduce the amount of salt you use, such as garlic, citrus juice, salt-free seasonings, or spices.
3. Increasing your physical activity has been found to lower total and LDL cholesterol while raising HDL levels.¹⁴ Plus, working out on a regular basis can improve your blood pressure.¹⁵ The American Heart Association advises aiming for a minimum of 150 minutes of moderate intensity exercise per week to reap these heart-healthy benefits. Just 10 minutes a day and you’re nearly half way there!
4. Manage stress. An uptick in stress and anxiety are common during menopause. Yet, feeling chronically stressed can increase your risk of cardiovascular disease. Fortunately, studies show that mindfulness meditation, relaxation exercises, deep breathing techniques, and engaging in enjoyable activities can help lower your stress levels, reduce the risk of stress-related heart disease, and improve your overall well-being.¹⁶
5. If you smoke, take steps to quit. It’s no secret that smoking increases the risk of cardiovascular disease. But it can also impact the timing of menopause and the severity of symptoms. Studies show that female smokers enter perimenopause at an earlier age than non-smokers.¹⁷ They also experience more severe symptoms like hot flashes, night sweats, and depression.^18,19 If you smoke, talk with your health care provider about ways to quit.
6. Support heart health with Age Garlic Extract. Taking a heart-smart supplement like Aged Garlic Extract (AGE) can also reduce several risk factors linked to cardiovascular disease. For instance, one double-blind randomized placebo-controlled trialinvolving 88 people with uncontrolled hypertension found that taking AGE lowered systolic blood pressure by as much as 11.5 mmHg and diastolic blood pressure by 6.3 mmHg after just 12 weeks.²⁰ Supplementing with AGE has also been shown to lower total cholesterol by 7 percent and LDL cholesterol by 10 percent.²¹ Plus, AGE reduces inflammation, arterial stiffness, and plaque buildup in arteries.^22,23  Adding beneficial supplements to your daily routine in a good step toward preventative care.

Although the symptoms of menopause fade over time, without taking action to improve the health of your heart, you may end up battling cardiovascular disease in your postmenopausal years. Work with your health care provider to make a plan to head off or improve your risk factors now and throughout your menopausal journey.

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2. Pardhe BD, Ghimire S, Shakya J, et al. Elevated cardiovascular risks among postmenopausal women: A community based case control study from Nepal. Biochemistry Research International. 2017;2017:3824903.
3. Liu J, Jin X, Chen W, et al. Early menopause is associated with increased risk of heart failure and atrial fibrillation: A systematic review and meta-analysis. 2023;176:107784.
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9. Yoshida Y, Chen Z, Baudier RL, et al. Early menopause and cardiovascular disease risk in women with or without type 2 diabetes: A pooled analysis of 9,374 postmenopausal women. Diabetes Care. 2021;44(11):2564-2572.
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13. Gupta DK, Lewis CE, Varady KA, et al. Effect of dietary sodium on blood pressure: A crossover trial. JAMA. 2023;330(23):2258-2266.
14. Muscella A, Stefàno E, Marsigliante S. The effects of exercise training on lipid metabolism and coronary heart disease. American Journal of Physiology: Heart and Circulatory Physiology. 2020;319(1):H76-H88.
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17. Oboni JB, Marques-Vidal P, Bastardot F, et al. Impact of smoking on fertility and age of menopause: a population-based assessment. BMJ Open. 2016;6(11):e012015.
18. Essa RM, Mahmoud NM. Factors associated with the severity of menopausal symptoms among menopausal women. Journal of Nursing and Health Science. 2018;7(2):29-40.
19. Kim H, Yoo J, Han K, et al. Associations between smoking, alcohol consumption, physical activity and depression in middle-aged premenopausal and postmenopausal women. Frontiers in Psychiatry. 2021;12:761761.
20. Ried K, Travica N, Sali A. The effect of aged garlic extract on blood pressure and other cardiovascular risk factors in uncontrolled hypertensives: the AGE at Heart trial. Integrated Blood Pressure Control. 2016;9:9-21.
21. Yeh YY, Liu L. Cholesterol-lowering effect of garlic extracts and organosulfur compounds: human and animal studies. Journal of Nutrition. 2001;131(3s):989S-93S.
22. Varshney R, Budoff MJ. Garlic and heart disease. Journal of Nutrition. 2016;146(2):416S-421S.
23. Gruenwald J, Bongartz U, Bothe G, et al. Effects of aged garlic extract on arterial elasticity in a placebo-controlled clinical trial using EndoPAT™ technology. Experimental and Therapeutic Medicine. 2020;19(2):1490-1499.

This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.