Link between menopause and heart risks

We're digging into the link between menopause and increased heart risks for women. So joining us is Dr. Jen Ashton. She's a four-time Emmy winner, double board certified OB/GYN, and Dr. Emily Lau, American Heart Association cardiologist. Thank you, ladies, for your time this morning. This is such an important cause. Dr. Ashton, let's start with you. So what is the link between menopause and increased heart risk? Is this something that women need to think about as they age? Right, and it's so important. and women are not really thinking about it enough, nor are there doctors. But, you know, if you think back 22 years ago, the American Heart Association started Go Red for Women, which really was meant to remind everyone in the world and here in the United States that heart disease is the number one killer of women. Now we're kind of doubling down on that effort to really increase the awareness that we know now conclusively that there are multiple OB/GYN risk factors menopause being one of them that really stack the deck for a woman to develop cardiovascular disease so the hormonal changes that a woman experiences in menopause are directly related to various factors that increase her risk so it's really about increasing that awareness not just for women like us but for the doctors and health care professionals taking care of those women it's such a tough time for women emotionally physically and this is one more thing for them to think about. It's great that we're raising awareness. Dr. Lau, you say it starts at perimenopause. Is that right? And what should women keep in mind? Yeah, so menopause is a time when cardiovascular disease risk really starts to take off. So as women go through the menopause transition, and we really do start to see these changes in that perimenopause period, so that period before the final menstrual period, we start to see that women's cholesterol levels increase, blood pressure can increase. We definitely know that body composition changes. For example, lean muscle mass will decline while women will start to accumulate much more fat mass. And all of these risk factors are really important risk factors for the development of cardiovascular disease many decades later. And so I really think about the menopause transition, the midlife period, as a time, as an opportunity for us to start having proactive conversations with our patients about what we can really do to try to optimize their heart health. Dr. Ashton, what do those conversations look like if maybe a woman isn't really experiencing any symptoms, but it sounds like we need to be proactive here. So what kind of conversation should we be having with our doctor? Yeah, for sure, all of us need to be proactive and realize that there's really no such thing as a woman at low risk for heart disease. It's really considered average risk. And so the first thing that I normally will tell women and their doctors is that if they've had a variety of OBGYN issues across their early lifespan, so a preterm birth, diabetes during pregnancy, PMOS, which used to be known as PCOS, those are risk factors for heart disease. So we've really gotten into a stage, which I think is exciting, where we're not waiting for women to have their first heart attack or get their diagnosis we're we're trying to screen for it and in fact prevent it with those conversations that a woman may have with a doctor other than a cardiologist and that that could be their well woman visit their annual exam and we have to remember that even a woman who is fit and at the normal or healthy weight still is at risk for cardiovascular disease. So that screening needs to be top of mind as does prevention. And you talk about prevention, Dr. Lau, as a cardiologist, what can women do today to protect them later on? Well, the first thing I tell all my patients is know your numbers. What are your cholesterol levels? What's your blood pressure? What's your weight? These numbers can then begin the conversation with your doctor about, well, what are the strategies that I need to take to be able to really try to preserve my cardiovascular health? And one of the things that the American Heart Association is doing now is really trying to connect the dots between a woman's health, women's health, menopause health and cardiovascular health, because it really is a team effort. And so thanks in large part to support from Dr. Ashton and her husband, we're creating this tremendous curriculum that really is meant to elevate the conversation about women's health and cardiovascular health. And this curriculum is going to be available to primary care physicians, OBGYNs, and cardiologists. I think it will really elevate our conversation in this space. Yeah, such an important conversation to keep top of mind, to have with your doctor, and just the awareness as a whole as women age and protect themselves after perimenopause and menopause. Dr. Lau, Dr. Ashton, thank you for your time this morning.