Dr. David Nabi, MD, FACS

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Menopause and the Link to CVD and PAD

The journey into menopause not only brings many changes, but it can also have risks that you need to be aware of. The word “menopause” comes from the Greek root words “men” (signifying month) and “pauein” (denoting cessation). According to the National Institute on Aging, menopause is medically diagnosed after 12 months of not having a period or spotting of any kind. It affects all women uniquely and at different ages. Some women experience symptoms like hot flashes, depression, fatigue, and insomnia, while others experience minimal to no symptoms.

Despite differing symptoms, menopause may put you at risk for cardiovascular diseases. In fact, according to Advances in Vascular Medicine, cardiovascular disease is the leading cause of death in women. “In women, the menopause transition may be a triggering event that leads to increased vascular vulnerability and accelerated vascular aging due to changes in the hormonal environment. As such, a further understanding of the biological defects mediating vascular aging in women as they transition through menopause and lose the protective effects of estrogen on the vasculature is needed.”

The strongest evidence for CVD risk is women who experience early menopause. According to the American Heart Association, the risk for cardiovascular disease for women who experience menopause by the age of 40 jumps to 40%. Early menopause affects women under the age of 45, whereas the average age for “natural” menopause is at approximately 50 and premature menopause is occurring before the age of 40.

According to a recent scientific statement from the American Heart Association, “the menopause transition, the years leading up to menopause, is a time of increasing heart disease risk for women.”

It is important for women who have undergone menopause before 40 to let their doctors know so they can implement a plan to prevent cardiovascular disease and monitor for ill effects due to vascular aging. 

Estrogen protects women’s bodies by controlling their cholesterol levels, so when menopause depletes estrogen levels, this can leave women vulnerable to heart disease as well as vascular diseases, like Peripheral Artery Disease (PAD). “The cardioprotective effects of estrogen may explain why women develop CVD a decade later than men. Similarly, it can be hypothesized that a decline in estrogen after menopause may explain the delayed, postmenopausal presentation of PAD in women.”

More research is needed to link CVD and PAD risks with the female population. Current evidence points to the fact that the prevalence of women who have Peripheral Arterial Disease may not just be equivalent to men, but even much higher. 

For this reason, the American Heart Association, along with the Vascular Disease Foundation (and its “Peripheral Arterial Disease Coalition”), “commissioned this scientific statement to summarize the evidence that describes the epidemiological burden of PAD in women.”

Meanwhile, it is important to be screened for PAD and CVD, especially if you went into menopause at an earlier age than normal. Many women can have PAD but be asymptomatic, which can lead to delayed care and grave outcomes. This is why screening for PAD and CVD is imperative, as well as eating healthy and daily exercise.

Get screened for PAD as soon as possible if you:

  • are over 50

  • overweight

  • smoke (even if you quit)

  • are diabetic

  • have high blood pressure or high cholesterol

  • have non-healing wounds

  • have a family history of PAD

Preventative care and screenings can be the key to staying healthy and having an excellent quality of life. If you would like to get screened or have concerns about your vascular health, contact Dr. David Nabi at NewportVascular.com today!