Menopause and Heart Disease

Medically Reviewed by James Beckerman, MD, FACC on September 11, 2026

Many women think that heart disease is a man's disease. It isn't. Heart disease is the number one killer of women. In fact, after age 50, nearly half of all deaths in women are due to some form of cardiovascular disease.

Once women reach the age of 50, about the age of natural menopause, their risk for heart disease increases dramatically. Young women who have undergone early or surgical menopause, who do not take estrogen, also have higher chances of having heart disease.  Women who have gone through menopause are at even greater risk if they also have any of these health and lifestyle conditions:

Race appears to play a role in your heart risk. Black people are more likely than white people to have severe high blood pressure, as well as heart disease. Heart disease risk is also higher among Mexican Americans, Native Americans, native Hawaiians, and some Asian Americans. This may be partly because of higher rates of obesity and diabetes.

A healthy lifestyle goes a long way in preventing heart disease in women. Incorporating the following tips into your everyday life may help you reduce your risk of heart disease during and after menopause:

  • Avoid or quit smoking. Smokers have twice (or higher) the risk of heart attack than nonsmokers. In addition to eliminating cigarettes, stay away from secondhand smoke, as it also increases the risk of heart disease.
  • Maintain a healthy body weight. The more you are over your ideal weight, the harder your heart has to work to give your body nutrients. Research has shown that being overweight contributes to the onset of heart disease.
  • Exercise throughout the week. The heart is like any other muscle -- it needs to be worked to keep it strong and healthy. Being active or exercising regularly (ideally, at least 150 minutes total each week) helps improve how well the heart pumps blood through your body. Activity and exercise also help reduce many other risk factors. It helps lower high blood pressure and cholesterol, reduces stress, helps keep weight off, and improves blood sugar levels. Check with your doctor if you have been inactive before increasing your activity level.
  • Eat well. Follow a diet low in saturated fat; low in trans fat (partially hydrogenated fats); and high in fiber, whole grains, legumes (such as beans and peas), fruits, vegetables, fish, folate-rich foods, and soy.
  • Treat and control medical conditions. Diabetes, high cholesterol, and high blood pressure make you more likely to have heart disease.

If you are considering hormone therapy (HRT) to manage your heart disease,  talk with your doctor about your individual heart risk factors, the specific type and timing of HRT, and the current evidence on benefits and risks. 

HRT is not recommended to lower heart disease risk. While HRT can have some benefits, it can also cause harm. Studies on the matter have had mixed results and are inconclusive.

You should discuss HRT with your doctor, as well as having a full conversation about any potential risks and benefits, cardiac and otherwise.

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