You've probably heard, but may not fully understand, the term “heart disease.” The umbrella term covers a wide range of diseases, illnesses, and events — known as cardiovascular diseases — that impact the heart and circulatory system. High blood pressure and coronary artery disease that can lead to stroke, heart attacks, and early death are some of the most common forms of heart disease for both men and women.

High Blood Pressure

For reasons that aren't entirely clear, women seem to lose their natural “protection” from cardiovascular disease when their estrogen begins to wane. Sometimes the first sign of this is a rise in blood pressure, also known as hypertension. When your blood pressure rises and stays elevated, it can lead to stroke, heart attack, or kidney failure. Sometimes this change happens slowly and the numbers creep up over time. Sometimes, for no apparent reason, a woman will suddenly have very high blood pressure. Menopause is the perfect time to begin tracking your blood pressure, in case you are one of the 35 million women who have high blood pressure.

Heart Attack

A heart attack, also known as myocardial infarction, happens when one of your arteries is blocked, keeping the heart from getting the blood it needs. Until recently, much of the research on cardiovascular disease was done on men, and the “classic” symptoms of a heart attack were not necessarily the same ones women experience. While women have a lower incidence of heart attacks than men until age forty-five, it quickly evens out. In later years, women surpass men in their risk of myocardial infarction. See Chapter 14 for more information on heart attacks in women.

Stroke

A stroke refers to damage in the brain caused by either a bleeding into the brain, or when a blood vessel to the brain is blocked and brain tissue does not get oxygen and nutrients. This damage to the brain can cause death or serious disability. Women are more likely than men to have a stroke, and more than 60 percent of stroke deaths are women. You are at higher risk for stroke as you get past forty-five, and in particular if you are a smoker, have a family history of stroke, or have untreated high blood pressure.

High Cholesterol

Cholesterol is a waxy sort of fat that is circulated in your bloodstream. Natural estrogen in your system prior to menopause seems to keep the “good” cholesterol (HDL) high, and the “bad” cholesterol (LDL) low. Once estrogen declines, this reverses and these fatty substances begin to block blood vessels in the same way they do in men. Women over forty-five have the same risk for high cholesterol as men, and begin to suffer from heart disease at the same rate. Chapter 14 has more information on cholesterol and ways to minimize its impact on your health. If you are over forty-five, get a baseline cholesterol test so you can monitor it over the next years.