08/28/2025
Women, Menopause and Heart Health
Fewer than 1 in 4 women in midlife maintain optimal cardiovascular (CV) health during the menopause transition, according to a new analysis of data from the Study of Women’s Health Across the Nation (SWAN). The findings, published in Menopause, linked higher scores on the American Heart Association’s Life’s Essential 8 (LE8) CV health framework to better vascular health, fewer CV disease events, and lower all-cause mortality.
The study, which included nearly 3000 women, also identified 4 LE8 components particularly influential in shaping long-term CV outcomes: blood glucose, blood pressure, sleep quality, and ni****ne use.
End-point cardiovascular disease
(CVD) events included myocardial infarction, stroke, heart failure, and revascularization and 161 deaths over a median 19 years of follow-up.
“Previously we’ve shown that the menopause transition is a time of accelerating cardiovascular risk. This study underscores that it’s also an opportunity for women to take the reins on their heart health.” (Study author)
The Biggest Bang for the Buck
Among individual LE8 components, favorable baseline or improving scores for glucose, blood pressure, and ni****ne exposure were consistently associated with reduced risk for all outcomes. Sleep quality also emerged as a notable factor, with better baseline or improved sleep associated with lower risk of CVD events and mortality, although not linked with subclinical measures such as carotid thickness.
In 2022, the AHA added healthy sleep as an essential component of CV health to the association's original Life's Simple 7, for the current LE8 elements. Both insufficient and excessive sleep are linked to increased risks of CVD, including hypertension, obesity, type 2 diabetes, stroke, and heart attack.
Starting in midlife women should work against the common changes in LE8 components, such as an increases in visceral fat (belly fat), elevated LDL cholesterol, and the tendency toward hypertension. Insulin resistance and high blood sugar levels should also be managed. Sleep disruption during menopause is a well-known problem with damaging effects that can also be modified to support long-term cardio protection.
“With heart disease being the leading cause of death in women, these findings point to the need for lifestyle and medical interventions to improve heart health during and after menopause," El Khoudary concluded.
Ask your doctor to work with you on optimizing all your Life Essentials (LE8) before it’s too late.
❤️🩺❤️🩹🩺❤️
P.S. A little secret I learned myself just recently: newer evidence from large Scandinavian studies in women using hormone replacement therapy without interruption into high age (90 years or older), being on HRT did NOT increase their risks for CVD or death from cardiac causes IF they had started hormone replacement therapy within 10 years from their menopause.
(Of course the high agers didn’t survive because of their HRT, but rather because of their healthy lifestyle, including the LE8 above.)💕