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Stroke, women are most at risk after menopause

January 1, 2018


The period marked by menopause is an important moment for women’s health, particularly cardiovascular health. After middle age, in fact, with the exit from the fertile period, the risk of stroke increases: in the ten years following menopause this risk almost doubles. What can a woman do to contain this risk? We talk about this with Dr. Simona Marcheselli, Head of the Operations Unit for Emergency Neurology and Stroke Unit at the Humanitas Hospital.



Hormones and cardiovascular wellbeing

The risk of stroke tends to increase with age, both in men and women. However, there are more events in the female sex, both because they tend to live longer than males and because the incidence of stroke is greater in the more advanced age groups.


The turning point is in the years following menopause, usually after the age of 50. The increase in risk is due to hormonal changes at the end of the reproductive age: androgen levels increase and estrogen levels decrease, in particular estradiol. Estrogen was responsible for the protective effect on cardiovascular health that women enjoyed up to menopause,” explains Dr. Marcheselli.

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The consequences of menopause

With menopause, cardiovascular risk factors can assume a greater weight: “It could, for example, increase the level of triglycerides in the blood, as well as the values of total cholesterol and “bad” LDL cholesterol. In addition, the waist circumference may increase with the accumulation of abdominal fat and change the metabolic profile with an increase in insulin resistance as well as blood pressure.


This possible acceleration of cardiovascular risk factors could make the post-menopausal phase an ideal time to focus on prevention: It is important for a woman to change her lifestyle in a healthier way, for example by stopping smoking, trying to stay active in the order of 150 minutes of aerobic physical activity, changing her diet with increased consumption of fruit and vegetables, wholegrain cereals, white meat and fish and limiting the consumption of red meat,” the specialist recalls.


If you arrive “prepared” for menopause, having led a healthy lifestyle it is naturally necessary to keep it in the years to come and in any case keep under control all the other cardiovascular risk factors, from hypertension to atrial fibrillation”.


The choice of following a hormone replacement therapy should be well thought out: “It cannot be understood as a means of prevention, of reducing the risk of stroke, but rather as the “pill” that can increase the risk of coagulopathy, in turn associated with a higher ischemic risk. The indication of hormone replacement therapy should be defined on the individual patient’s health condition by a specialist,” concludes Dr. Marcheselli.

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