• Posted May 13, 2026

Perimenopausal Women Face Greater Heart Risk, Study Finds

Women entering menopause are twice as likely to have lower heart health scores than those still having regular periods, a new study says.

Perimenopausal women are more likely to have high cholesterol and blood sugar levels, researchers reported today in the Journal of the American Heart Association.

These problems likely are fueled by varying estrogen levels, which can negatively affect cholesterol, insulin resistance, blood pressure and weight, researchers said.

But diet also plays a powerful role, with women’s healthy nutrition scores declining as they begin and then enter menopause, the study found.

“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,” said senior researcher Dr. Garima Arora, an professor of medicine at the University of Alabama at Birmingham.

“Women should talk with their health care team about their reproductive status and any changes they are experiencing,” Arora said in a news release. “It may be the perfect time to get a baseline for their heart health.”

For the new study, researchers assessed more than 9,200 women’s heart health using the American Heart Association’s Life’s Essential 8, which tracks tracks lifestyle factors (diet, physical activity, tobacco use and sleep) and health metrics (blood pressure, cholesterol levels, body weight and blood sugar levels).

The women, ages 18 to 80, participated in a federal health and nutrition survey between 2007 and 2020.

The team looked specifically at perimenopause, the time at which women’s hormone levels start to fluctuate and their menstrual cycles become irregular. A woman is considered past menopause when 12 consecutive months pass after her final period.

Results showed that women’s LE8 scores declined steadily, from 73 out of 100 in premenopausal women to 69 in perimenopausal women and 64 for women post-menopause.

Women undergoing menopause were twice as likely to have an overall low heart health score than those who hadn’t yet started menopause, even after researchers accounted for the effect of aging.

They also were 76% more likely to have higher cholesterol and 83% more likely to be struggling to control elevated blood sugar, the study found.

“Our analysis highlights that perimenopause, women’s reproductive transition period to menopause, is the critical time when the increase in cardiovascular risk seems magnified,” lead researcher Dr. Amrita Nayak said in a news release. Nayak is a research fellow in cardiovascular disease at the University of Alabama at Birmingham.

Diet consistently received the lowest score across all eight heart health factors, researchers noted.

“Nutrition can be a central factor for early and proactive intervention,” Arora said. “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.”

Researchers next plan to follow a group of women over several years to track their hormone levels and heart health, researchers said.

“I encourage women to talk with their primary care and specialty health care teams to learn about early detection and modification of traditional and ‘female-specific’ risk factors,” Dr. Stacey Rosen, volunteer president of the American Heart Association, said in a news release.

“Women can take proven steps to improve their cardiovascular health at all ages,” added Rosen, who reviewed the findings.

More information

Johns Hopkins Medicine has more on menopause and heart health.

SOURCE: American Heart Association, news release, May 13, 2026