When cardiovascular risk factors deteriorate with the onset of menopause or...why take action!

Dr Brigitte Raccah-Tebeka, gynecolo-endocrinologist in Paris and ambassador for Agir pour le Cœur des Femmes, has read for you this prospective Japanese study evaluating the cardiovascular follow-up and outcome of women entering menopause, and comparing them with those of men of the same age.

These "gendered" studies are important to better understand preventive medicine in these women and to act on their lifestyle behaviors. The changes in cardiovascular risk factors in post-menopausal women are well known, compared with those in genitally active women. It has also been shown that early (and/or surgical) menopause is associated with higher overall mortality, particularly from cardiovascular causes. But let's not forget that cardiovascular and metabolic diseases are also linked to the way we move, eat and are exposed to stress, and that in 8 out of 10 cases, a cardiovascular accident can be avoided by identifying risk factors and managing them appropriately at this key turning point, the menopause.
This recent Japanese publication confirms the alteration of numerous metabolic parameters during the transition to menopause. The study is unique in that it is longitudinal, with an average follow-up of almost 11 years, allowing us to follow women who were initially premenopausal but who became menopausal during the follow-up. From a cohort of 4,596 women, 263 became menopausal during the course of the study. The mean age at recruitment was 47.6 years. The average age at menopause was 51.4 years. They were compared with a group of men of the same age who were examined and tested at the same time.
Compared to the men, the women showed a statistically more marked deterioration in many of their metabolic parameters: greater increases in total cholesterol, LDL cholesterol, triglycerides, uric acid, hemoglobin and liver enzymes. On the other hand, changes in body mass index, systolic and diastolic blood pressure and glycated haemoglobin were similar to those seen in men during the observation period.
In conclusion, many metabolic and vascular factors are altered, in relation to the hormonal changes of the menopause. A healthier lifestyle is therefore essential, ideally combining a balanced diet, physical activity, stress management, sleep and smoking cessation. The onset of menopause should be a key time for women to undergo systematic cardiovascular and metabolic screening. By taking action as soon as women enter menopause, we can prevent many of these cardiovascular accidents, which have become the leading cause of death in women in the space of 40 years.

Bibliographical reference
S Temamura, T Sankai, K Yamagishi et al. Changes in cardiovascular disease risk factors during menopausal transition in japanese women: the circulatory risk in communities study (CIRCS). Menopause. 2023, 30 ; 88-94.

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