Heart disease risk increases with age for everyone, but symptoms often become more evident in women after the onset of perimenopause. Although menopause doesn't directly cause heart disease, the risk of developing it rises with the onset of menopause, according to the American Heart Association (AHA). One factor that may contribute is the decline in estrogen.
Estrogen plays a protective role in cardiovascular health by helping keep blood vessels open and flexible, allowing them to relax and expand for better blood flow. A buildup of plaque in the blood vessels leading to the heart or brain can result in a heart attack or stroke. Estrogen helps reduce atherosclerosis by reducing levels of low-density lipoprotein (LDL) or “bad cholesterol,” decreasing inflammation in the vascular system, and possibly acting as an antioxidant.
More than one in three adult women has some form of cardiovascular disease. An increase in heart attacks is typically observed among women about 10 years after menopause. Heart disease is the leading cause of death among women in the United States.