Menopausal Women at Lower Heart Risk Than Men of Similar Age

Study found little difference between menopause types, but black women had less advantage than white

Wednesday, July 1, 2015

WEDNESDAY, July 1, 2015 (HealthDay News) -- Menopause is commonly considered a risk factor for heart disease, as the protective effect of estrogen declines. However, in a new study, researchers found that postmenopausal women had a lower risk of dying from heart attack than did men of similar ages.

"Women have lower cardiovascular disease risk than men, even after menopause," said the study's lead researcher, Dr. Catherine Kim, an associate professor of medicine at the University of Michigan in Ann Arbor. "But the advantage is seen primarily in white women compared to white men; black women have less of an advantage compared to black men."

Although some research has suggested that natural menopause does not boost heart disease risk but surgically induced (after hysterectomy and ovary removal) menopause does, Kim did not find much difference in risk between menopause types.

Her long-term study found: White women who went through natural menopause had a 55 percent reduced risk of nonfatal heart attacks and other heart events compared to white men. White women who had surgically induced menopause had a 35 percent reduced risk. Black women who had natural menopause had a 31 percent reduced risk of nonfatal heart attacks compared to black men, while black women who had surgically induced menopause had a 19 percent reduced risk.

The study, published July 1 in the Journal of the American Heart Association, is believed to be the first to compare men and women and how menopause type affects heart disease risk, according to Kim.

Her team looked at more than 23,000 men and women, all older than 45, who were enrolled in a study between 2003 and 2007 and had no heart disease at the study start. The researchers followed them until the end of 2011.

Kim can't fully explain the findings on postmenopausal women. "It is unknown why their risk remains low,'' she said. "It is possible it is a residual effect of the estrogen, but estrogen therapy studies have shown no benefit for cardiovascular risk to date." Nor can she explain the racial differences, she added.

She also found that the risk of heart attack does not seem to increase for women the further they are from menopause.

Dr. Gregg Fonarow, a cardiology professor at the University of California, Los Angeles, noted, "These findings suggest that other factors besides menopause status and established coronary heart disease risk factors may account for sex differences in midlife."

Fonarow, who was not involved in the research, added, "While prior studies have suggested a rapid rise in risk in women after 50, the risk observed in this study was more gradual. Additional studies are needed to better understand what may account for the differences observed."

All women should try to reduce risks as they can, Kim said. "Although we all grow older, we can continue to exercise, maintain a healthy weight, and ensure that our blood pressures are controlled."

Fonarow agreed. "These findings highlight that women should focus on achieving and maintaining heart health irrespective of their age and menopausal status," he said. "This includes regular physical activity, not smoking, and maintaining healthy blood pressure, cholesterol levels and body weight."

SOURCES: Catherine Kim, M.D., M.P.H., associate professor of medicine, University of Michigan, Ann Arbor; Gregg Fonarow, M.D., professor of cardiology, University of California, Los Angeles, David Geffen School of Medicine; July 1, 2015, Journal of the American Heart Association

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