Management of cardiovascular risk in the peri-menopausal woman: a consensus statement of European cardiologists and...

Area of Science:

• Cardiology
• Women's Health
• Endocrinology

Background:

• Cardiovascular risk is poorly managed in women, with increased susceptibility during the menopausal transition.
• Significant gender differences exist in cardiovascular disease epidemiology, symptoms, diagnosis, progression, prognosis, and management.
• Peri-menopausal women require control of hypertension, dyslipidaemia, obesity, and metabolic syndrome, alongside diabetes management.

Framework:

• Hypertension is a critical risk factor, making blood pressure reduction pivotal.
• Hormone replacement therapy (HRT) effectively alleviates menopausal symptoms but is not recommended for cardiovascular disease prevention due to WHI study concerns.
• The applicability of WHI findings from older post-menopausal women to younger peri-menopausal women remains unclear.

Implementation:

• HRT is increasingly recognized as inappropriate for older post-menopausal women without menopausal symptoms.
• Gynaecologists and cardiovascular physicians must collaborate to identify and manage cardiovascular risk factors in peri-menopausal women.
• Team-based management is essential for addressing hypertension and other risk factors.

Implications:

• Improved cardiovascular risk management strategies are needed for women, especially during menopause.
• Multidisciplinary collaboration is key to mitigating cardiovascular morbidity and mortality in this population.
• Further research is required to clarify HRT's role and cardiovascular risk in younger peri-menopausal women.