Heart disease risk factors -- such as abnormal cholesterol levels and high blood pressure -- appear to increase before a woman goes through menopause, not after, new research finds.
"These risk factors related to heart disease and stroke appear to worsen rapidly in the years leading up to menopause, and during the postmenopausal period they progress less rapidly," said Dr. Mark DeBoer, the study's senior author. He's an associate professor of pediatric endocrinology at the University of Virginia.
In the past, he said, experts believed that a rapid increase in heart disease and stroke risk factors took place in women after menopause. They thought this was when women "catch up" to men's risk.
However, the new research finds the rapid increase in risk factors starts well before the last menstrual period. The real danger zone, DeBoer's team concluded, was before and during menopause. And, the transition began even sooner and progressed faster for black women, the researchers found.
For the study, the researchers evaluated the medical records of nearly 1,500 women enrolled in a national study looking at the causes and effects of hardening of the arteries. The women were studied over a 10-year period as they transitioned through menopause.
The researchers looked specifically for five risk factors for heart disease and stroke. These included a large waistline, high blood fat levels (triglycerides), low "good" cholesterol or HDL, high blood sugar and high blood pressure.
Together, these risk factors are called "metabolic syndrome," the researchers said. Metabolic syndrome significantly raises the risk of type 2 diabetes, heart disease and other health problems.
Overall, DeBoer's team found, women had a rapid increase in these risk factors during the last years of premenopause and during the perimenopause transition, right before menopause.
DeBoer said it's not possible to quantify exactly how much the risk factors increased. But "there was a continued worsening of risk factors in the years leading up to the transition," he said.
After menopause, the changes generally plateaued, though white women continued to have drops in their HDL cholesterol levels. Black women seemed to fare slightly better in postmenopause, with a slowing in the progression of metabolic syndrome, the study reported.
The findings were published online Aug. 3 in the Journal of the American Heart Association.
Dr. Suzanne Steinbaum is director of women's heart health at Lenox Hill Hospital in New York City. She said the study suggests that "the risk factors go up even sooner than we thought," and should be a wakeup call.
Both DeBoer and Steinbaum agreed that the take-home message is to pay attention to lifestyle and modify it when needed well before menopause.
Steinbaum recommends women be sure their weight is under control, their diet is healthy and that they are getting enough exercise.
The study results should provide doctors and other health care professionals with convincing information to motivate women before they go through menopause to decrease the risk of getting health problems, DeBoer said.
To learn more about preventing metabolic syndrome, visit U.S. National Heart, Lung, and Blood Institute.