Menopause and heart disease intersect in powerful ways. In this episode of The Menopause Reset Podcast, hosts Susan and Karen explain why risk rises after periods stop and how to protect your heart with numbers that matter, smart tests, food and movement, sleep and stress tools, and clear medication context including HRT.
What we cover
- Risk timing: the decade after the final period is a critical window; arteries stiffen, LDL rises, BP can creep.
- Numbers that matter: LDL-C, ApoB, home blood pressure, A1c/fasting glucose, waist trend, and a once-in-lifetime Lp(a).
- Testing options: fasting lipids when TGs run high, ApoB for particle count, coronary artery calcium (CAC) for risk reclassification in selected patients.
- Women’s symptoms: pressure or tightness, shortness of breath, unusual fatigue, nausea, jaw or back or arm discomfort.
- Mediterranean plate: half vegetables, quarter protein (fish, beans, tofu, poultry), quarter smart carbs (whole grains or potatoes with skin), plus olive oil or nuts; target 25–30 g fiber/day with 10–15 g soluble from oats, barley, beans, flax.
- Movement prescription: 150+ min/week brisk cardio, strength 2×/week, more daily steps and stairs, optional low-impact intervals if cleared.
- Sleep and stress: cooler dark bedroom, lights down an hour before bed, caffeine by noon, two minutes of 4-in/6-out breathing or a short outdoor walk for calm.
- Tobacco and vaping: quit plans with coaching and medications protect the heart; vaping is not heart safe.
- Medications: statins first line to lower LDL and events; add ezetimibe as needed; consider PCSK9 inhibitors or inclisiran for high risk or intolerance; BP meds include thiazides, ACE inhibitors, ARBs, calcium-channel blockers; aspirin only when clinician directed.
- HRT context: prescribed for symptom relief, not for heart disease prevention; many clinicians prefer transdermal estrogen with micronized progesterone when cardiometabolic risk exists; monitor BP and lipids with therapy changes.
- Risk enhancers: family history of early heart disease, elevated Lp(a), pregnancy complications (preeclampsia, gestational diabetes), autoimmune disease, smoking.
- Visit prep: one-page snapshot with last two lipid panels, ApoB/Lp(a) if available, 7-day home BP averages, A1c or fasting glucose, meds and supplements, sleep and alcohol patterns, family history, and a clear goal.
Try this tonight: fish or bean-based dinner with vegetables, whole grain, and olive oil, then a 10-minute walk. Set the bedroom cooler and lay out clothes for a morning walk.
This week: schedule 3 brisk walks and 2 strength sessions, swap butter for olive oil, add oats or barley at breakfast three times, check home BP morning and evening for 7 days, and book labs if due.
Safety flags: new chest pressure, shortness of breath, fainting, one-sided weakness, or jaw and arm pain that does not ease require emergency care.
Keywords: menopause heart disease, women and heart disease, LDL, ApoB, Lp(a), coronary calcium score, CAC, blood pressure, Mediterranean diet, soluble fiber, exercise, strength training, statins, ezetimibe, PCSK9, inclisiran, aspirin, HRT, transdermal estrogen, micronized progesterone, women over 40, The Menopause Reset Podcast.
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Disclaimer: This podcast is for informational purposes only and is not medical advice. Please consult your healthcare professional for personalized guidance.
