Woman's cardiovascular risks increase after going through menopause: study

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AUSTIN, Texas - When you think about menopause, hot flashes probably come to mind, but there is so much more to it than that.

A recent study by the American College of Cardiology found a woman's cardiovascular risks sharply increase after going through menopause.

Dr. John Moscona, interventional cardiologist at Heart Hospital of Austin, joined FOX 7 Austin's Rebecca Thomas to talk more about the study's findings.

REBECCA THOMAS: Doctor Moscona, for those who don't know, menopause is, of course, the end of having periods for women and a drastic drop in estrogen. First, tell us about the study and how it was conducted.

DR. MOSCONA: Sure. So in this study, really the researchers were looking at kind of two comparison groups, sort of what is happening in life with men kind of sort of middle to later age, but comparing it to women just post-menopausal by looking at something called a coronary artery calcium (CAC) score. So that's the kind of test used to assess risk of blockage in the heart arteries.

REBECCA THOMAS: So that's the CAC score and what scans are used to assess that. And of what kind of blockages would that consist of?

DR. MOSCONA: Yeah that's right. So a coronary artery calcium score. So that's a scan that's really done with a CAT scan. But it's really more like an X-ray. It's a really low dose radiation CAT scan that can basically quantify how much plaque, how much blockage has built up in the heart arteries over time. It's a really good test to figure out, you know, sort of. Hey, if I have a lot of plaque, a lot of blockage built up over my life, then I'm going to be at higher risk to having those blockages may lead to heart attack or, you know, heart disease. So the higher the number, the worse the blockage.

REBECCA THOMAS: Should menopausal women be getting these scans even if they don't have symptoms?

DR. MOSCONA: Yeah, that's a great question. Actually, the answer is emphatically yes. That's the purpose of this very specific test. So there are a lot of tests in cardiology and medicine that we do when there's a symptom. This is one that was designed for people who are completely asymptomatic. It's a test that falls in prevention in terms of, you know, somebody who's very healthy, active exercises. The idea is, can we get a snapshot of maybe what the future may hold and try to sort of limit that risk? If someone is at high risk, let's say 10 years down the line or 10 years from now to have a heart attack, how can we lower the risk that that will happen?


REBECCA THOMAS: So again, the risk is increased in menopausal women. What role does estrogen play in keeping the female heart healthy and preventing cardiovascular disease?

DR. MOSCONA: Yeah, that's a good question. Nobody really knows exactly. I think that what we sort of see more and more in terms of a trend is that it's sort of related to the aging process, just meaning that as we go through life, there are many different hormonal changes, kinds of men and women. And obviously, when menopause occurs and the estrogen goes down, there seems to be almost an uptick then in testosterone, so that those women, basically, kind of have this shift occur that, almost in a sense, causes aging, to the heart arteries. That's that's probably the best overall understanding right now about how it works. But it's actually pretty unclear.

REBECCA THOMAS: Should menopausal women be talking with their doctors about taking estrogen, or what's known as menopausal hormone therapy and hormone replacement therapy?

DR. MOSCONA: Yeah. I mean, that's a good question. It's a little complicated about maybe who should or shouldn't. There's a lot more to that than just the heart. I think that the big question that kinds of women should maybe ask their doctors is more, hey, should I have more? Maybe preventative testing like this coronary artery calcium score scan does things like that and kind of addresses, basically, risk factors related to developing heart disease.

REBECCA THOMAS: And as far as other tests, there's cholesterol. What else should women consider?

DR. MOSCONA: Yeah. No, I think that's what starts with cholesterol. It is a good example. The calcium score is a great example. Screening for diabetes, which is done with blood tests, things like that. There are a lot of kinds of blood testing for risk factors, diabetes, high cholesterol. And then these calcium scores are really kind of the top three. If you had to pick, three tests.

REBECCA THOMAS: And what advice do you have for women when it comes to protecting their heart health as they enter menopause or are postmenopausal?

DR. MOSCONA: Yeah. I think the first bit is, maybe it's sort of a check in to first say, hey, do I see my doctor regularly? And maybe I should see a cardiologist? And maybe get a sense of, you know, how active am I? What is my diet like? You know, a lot of these sorts of lifestyle kind of wellness questions. That I think are kind of a starting point and obviously always can start with your doctor to kind of run through those things and figure out where to go next.

REBECCA THOMAS: Okay, we are out of time. But Dr. John Moscona, of Heart Hospital of Austin, thank you so much for sharing your time and expertise with us tonight.