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Intradermal Microdialysis: An Approach to Investigating Novel Mechanisms of Microvascular Dysfunction in Humans
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Published on: July 21, 2023

Coronary microvascular dysfunction in menopausal women.

Denin Mathew1, Wanqi Wang1, Vijay Kunadian2,3

  • 1Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.

Heart (British Cardiac Society)
|June 22, 2026
PubMed
Summary

Coronary microvascular dysfunction (CMD) disproportionately affects menopausal women, increasing cardiovascular disease (CVD) risk. More research is crucial to address sex-specific pathophysiology and improve women

Keywords:
Angina PectorisCoronary Artery DiseaseMicrovascular Angina

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Area of Science:

  • Cardiology
  • Women's Health
  • Vascular Biology

Background:

  • Cardiovascular disease (CVD) is the leading global cause of death.
  • Coronary microvascular dysfunction (CMD) is increasingly recognized in menopausal women, contributing to chronic coronary syndrome (CCS).
  • Hormonal shifts and metabolic changes during menopause accelerate vascular aging and endothelial dysfunction in women.

Purpose of the Study:

  • Highlight research gaps in understanding the sex-specific pathophysiology of CMD in menopausal women.
  • Emphasize the need for tailored diagnostic and treatment strategies for women with CMD.
  • Advocate for sex-specific research to improve risk stratification and prognosis in this cohort.

Main Methods:

  • Review of existing literature on CMD, menopause, and cardiovascular disease in women.
  • Analysis of prevalence and risk factors for CMD in menopausal women.
  • Examination of sex differences in CMD pathophysiology and clinical presentation.

Main Results:

  • CMD is more prevalent in women than men, associated with higher risks of adverse cardiovascular events and mortality.
  • Menopausal women with CMD are frequently diagnosed with Takotsubo syndrome and heart failure with preserved ejection fraction (HFpEF).
  • Current clinical guidelines often rely on male-dominant data, leading to potential misdiagnosis and suboptimal treatment for women.

Conclusions:

  • Significant knowledge gaps exist regarding the sex-specific mechanisms of CMD in menopausal women.
  • Current diagnostic and treatment approaches may not adequately address sex differences, impacting women's prognosis.
  • Further sex-specific research is essential to achieve health equity and reduce the burden of CVD in menopausal women.