Targeting women at risk of CVD at midlife: a challenge to the physician

Abstract

The menopause transition is a period of accelerated cardiovascular disease risk. While menopause does not directly cause heart disease, several cardiometabolic changes occur due to declining estradiol and ovarian aging. Studies have demonstrated that lipoproteins dramatically increase the year before through the year after the final menstrual period, independent of the effect of aging alone. In addition, adverse changes in body fat distribution (central weight gain) increases the risk for metabolic syndrome and has been related to menopause transition independent of aging. By midlife, it is estimated that ninety percent of women have at least one risk factor for cardiovascular disease; therefore, targeting women at risk for CVD at midlife will have substantial implications for prevention.