Winter 2022

Is it Menopause or Could it be Heart Disease?

By Dr. Shalini Bobra

Hot flashes, night sweats, unexplained fatigue. Most women recognize these as signs of menopause, but they might be surprised to learn that these ailments could also be signs of heart disease – the #1 killer of women.

It’s important to understand that menopause doesn’t cause heart disease, but the risk certainly increases around this stage of life. To further complicate matters, some common symptoms of a heart problem could mimic what we tend to think of as menopausal symptoms.

Before menopause, the risk of heart disease is low in women. The reason? Estrogen is a friend to blood vessels, keeping them flexible and adaptable to blood flow. When estrogen levels decline as a result of menopause, the blood vessels lose some of that resilience, upping the risk of arteriosclerosis, a clogging of the blood vessels. In fact, an overall increase in heart attacks among women is seen about 10 years after menopause, according to the American Heart Association.

Know the Risks at Any Age

Women have their own unique set of conditions that predispose them to heart problems. Otherwise healthy women who sit too much, maybe as a result of being locked in during the pandemic, may be at greater risk of a heart attack. One study showed that having an autoimmune disease (rheumatoid arthritis, lupus, etc.) doubles the risk of cardiovascular disease, due to chronic inflammation. In addition, those who are dealing with ongoing states of stress or depression – leading to elevated stress hormones that can increase blood pressure – are also at risk for heart disease.

Get a Symptom Check

If you’re around the age of menopause (average age around 51) and have been noticing the following signs, take pause and consider consulting with a Cardiologist or Internal Medicine specialist:

• Fatigue. It’s natural to feel more tired as you age, and it’s a common menopausal complaint. But if simple activities like carrying the laundry upstairs or walking out to the mailbox that were once a breeze are now suddenly difficult, this could be a warning sign.

• Sweating. Three-quarters of all women experience hot flashes during menopause. It’s worth mentioning to your physician if these sweats are associated with shortness of breath or chest pain, especially when you haven’t been exerting yourself or there doesn’t seem to be any real cause. 

• Chest Pain. While chest pain alone isn’t necessarily a menopause symptom, it’s worth mentioning that it is the most commonly ignored symptom by women who suffered a heart attack and then reflected on what they had experienced beforehand, according to a 2012 study by the University of Barcelona. Chest pain isn’t always the “grip your chest”; it could be just simple discomfort, pressure, or feeling that something isn’t right.

The good news is that, despite this long list of risk factors, 80 percent of cardiac events can be prevented with small, simple daily changes. The first and foremost change would be to quit smoking. I tell my patients another simple step is to just move 30 minutes a day. Also, adopting a Mediterranean style diet focusing on greens and grains, legumes, and lots of fiber has proven to benefit the heart.

Dr. Shalini Bobra is a cardiologist with White Plains Hospital Physician Associates, seeing patients at 99 Business Park Drive in Armonk. To make an appointment, call 914-849-7900.