The risk of heart problems increases significantly for women once they reach menopause. This is because of the drop in oestrogen levels, which help protect women from heart disease by supporting the flexibility of the blood vessels and arteries enabling them to adjust to support blood flow.

The drop in oestrogen in menopause can also lead to a number of other factors that increase a women’s risk of CVD, including:

• higher blood pressure
• higher total cholesterol
• higher ‘bad’ cholesterol
• lower ‘good’ cholesterol
• higher blood fats such as triglycerides
• excess weight gain, particularly around the stomach

Some studies have suggested that menopausal hormone therapy (MHT) may help reduce the risk of CVD for some women.

Symptoms

Studies on cardiovascular disease have traditionally focused on men. As a result, women are often diagnosed and treated for CVD based on research findings about men. What we now know, however, is that the symptoms, risk factors and overall experience of CVD can be quite different for women.

Women tend to develop symptoms at a much later stage of the illness. They are also less likely to experience chest pain and may instead experience other symptoms, including:

• discomfort in the neck, jaw, shoulder, upper back or abdomen
• breathlessness and a general feeling of unwellness
• pain, tightness or discomfort in one or both arms
• nausea or vomiting
• heartburn or indigestion
• sweating
• light-headedness or dizziness
• unusual fatigue

Women are also more likely to have heart attack symptoms when resting, or even when asleep, compared to men.