Menopause causes a rapid decline in women’s heart health, putting them at the same risk as men of the same age, research suggests.
The drop in estrogen levels can cause plaque buildup in the arteries, which statins did not appear to prevent, a study has found.
Experts say this shows the importance of recognizing early warning signs of cardiovascular disease risk in women and the need for different treatments.
Researchers studied 579 postmenopausal women who were already taking statins to control their cholesterol.
They were given coronary calcium scans (CAC) – similar to an X-ray – to measure the build-up of fats, calcium and other heart disease-related substances in the heart arteries.
The drop in estrogen levels can cause plaque buildup in the arteries, which can cause heart problems
The number of HRT prescriptions for menopausal women has increased dramatically in recent years, with 11 million items distributed in 2022/2023 to help manage symptoms
Two scans were given, a year apart, with the higher the CAC score, the greater the risk of a heart attack or other cardiac events.
Researchers at Harbor-UCLA Medical Center, California, initially divided participants into three groups with CAC levels of 1–99, 100–399, and 400 or higher.
Between their first and second heart scan, women with a CAC of 1-99 saw it increase by an average of eight points, double the four points seen in equivalent men.
Similarly, women’s average CAC score increased by an average of 31 points, almost double the 16 in men.
There was no significant difference between the sexes in those with the highest baseline readings, according to findings presented at the American College of Cardiology’s annual scientific session.
The findings suggest that plaque buildup occurs more quickly in postmenopausal women than in men, indicating that many women experience a sharp increase in the risk of heart problems.
Dr. Ella Ishaaya, lead author, said: ‘After menopause, women have much less estrogen and switch to a more testosterone-heavy profile.
‘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 they all increase the risk of developing heart disease.’
Heart disease has traditionally been considered a man’s disease, despite women in Britain being twice as likely to die from it as breast cancer.
Inequalities in diagnosis and care compared to men have resulted in more than 8,200 preventable heart attack deaths among women in England and Wales in a decade, previous research has found.
Professor Vijay Kunadian of the British Heart Foundation said: ‘Menopause increases the risk of heart attack and other cardiovascular diseases because it leads to a drop in oestrogen, a hormone that protects the heart.
‘Menopause can also cause changes in a woman’s body that increase the risk of developing cardiovascular disease, such as high blood pressure, high cholesterol and an increase in abdominal fat storage, often through no fault of the woman herself.
‘This study highlights that statins alone are not enough to help reduce the risk of cardiovascular disease for women. We must equip women with the tools and knowledge to take charge of their own health and turn to doctors for help to protect them from future heart problems.”