Menopause and cardiovascular disease.

: As the life expectancy of women increases, a greater percentage of women's lives will be spent in the menopause. The greatest cause of morbidity and mortality during that period is cardiovascular disease. The associated risks that predispose to the development of cardiovascular disease are multifactoral and include hypertension, diabetes mellitus, smoking, obesity, family history, and elevated cholesterol levels. The menopause, per se, is associated with an increased risk because of the unfavorable changes in cholesterol metabolism secondary to estrogen deprivation. The replacement of estrogen to menopausal women is believed to improve the lipid profile and reduce the atherogenic changes that increase the risk of cardiovascular disease. However, this form of preventative therapy is futile unless other factors that promote cardiovascular disease also are modified. Such modification may be achieved by following a well-balanced diet, combined with an exercise program, cessation of smoking, weight control, and the monitoring of blood pressure and diabetes in high-risk patients.