Chapter 11 – Menopause

Cardiovascular disease

Cardiovascular disease is the main cause of morbidity and mortality in women in westernised countries and risk increases with age, particularly after the menopause.(61) It is important to assess for and recognise risk factors in menopausal patients and to treat them aggressively.

Significant risk factors include hypertension, cigarette smoking, dyslipidaemia, diabetes mellitus, high BMI, and the metabolic syndrome. Each patient needs to be assessed individually, but in general, MHT does not increase CHD risk in healthy women between 50 and 59.(36) It is unclear at present whether MHT in healthy women 50-59 may slightly increase the risk of ischaemic stroke although no increase in stroke was seen in this age group in the Women’s Health Initiative study.(62)

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