A new analysis of nationwide U.S. data published today in the Journal of the American Heart Association reveals that perimenopausal women are twice as likely to have a low cardiovascular health score compared to women with regular menstrual cycles. The study, which used the American Heart Association's Life's Essential 8™ (LE8) health metrics, underscores perimenopause as a critical window for heart disease prevention.
Perimenopause, the transitional period from reproductive to non-reproductive phases, is marked by hormonal and metabolic changes that can accelerate cardiovascular health decline. According to the analysis, median LE8 scores declined with advancing reproductive stage: from 73.3 out of 100 in premenopausal women to 69.1 in perimenopausal women, and to 63.9 in postmenopausal women. After accounting for aging, perimenopausal women were twice as likely to have a low overall LE8 score, 76% more likely to have a low cholesterol score, and 83% more likely to have a low blood sugar score compared to premenopausal women.
Dr. Garima Arora, senior author of the study and a professor of medicine at the University of Alabama at Birmingham, emphasized the importance of this period. "Mid-life women should think of the perimenopausal period as a 'window of opportunity.' They should be proactive and not wait until they reach menopause to start checking their blood pressure, cholesterol, and blood sugar levels," she said. The study included 9,248 women aged 18 to 80 from the National Health and Nutrition Examination Survey (2007-2020).
The findings highlight that diet consistently received the lowest scores among LE8 components and continued to decline across reproductive stages. Fluctuating estrogen levels during perimenopause may contribute to worsening cholesterol, insulin resistance, blood pressure, and weight management. Despite perimenopausal women reporting difficulty sleeping, sleep duration scores remained high, suggesting sleep quality may be more affected than quantity.
Dr. Amrita Nayak, lead author, noted, "Our analysis highlights that perimenopause is the critical time when the increase in cardiovascular risk seems magnified. When we compared women's LE8 scores to the premenopausal baseline, the perimenopausal group was the first to show a significant jump in the odds of having low heart health." The American Heart Association's 2020 scientific statement previously emphasized that the menopause transition increases cardiovascular disease risk and is an important time for early intervention.
Dr. Stacey E. Rosen, volunteer president of the American Heart Association, who was not involved in the study, commented, "This research highlights yet another aspect of the unique factors that increase a woman's risk of cardiovascular disease throughout the stages of her lifespan. Significant health changes during pregnancy, perimenopause, and menopause make it particularly important to pay close attention to increases in health risk factors during those times." She encouraged women to discuss early detection and modification of risk factors with their healthcare teams.
The study's next steps involve following women over several years to track hormone levels and heart health, clarifying the long-term impact of perimenopause and how lifestyle changes can reduce risk. Dr. Arora added, "Nutrition can be a central factor for early and proactive intervention. Focusing on heart-healthy habits early, especially getting regular exercise and following a healthy eating plan like the DASH diet with a focus on lowering salt, can help improve cardiovascular health for perimenopausal women in the years to come."
For business and technology leaders, this research underscores the importance of women's health monitoring and preventive care, potentially influencing workplace wellness programs and health insurance policies. As the workforce ages, understanding these critical health transitions can help companies support employees and reduce long-term healthcare costs.
