Study offers new insights into link between menopause and cardiovascular health

Post-menopausal women show higher cholesterol even in populations with the world’s healthiest hearts, suggesting menopause affects cardiovascular health everywhere.

Researchers studying the Tsimane, a forager-horticultural community in the Bolivian Amazon with exceptionally low heart disease rates, found their post-menopausal women had rises in blood lipids – fats in the blood such as cholesterol that contribute to heart disease.

Five of the six measured factors, including triglycerides, total cholesterol and low-density lipoprotein (LDL) cholesterol, were 1.5 to 11 per cent higher after menopause in Tsimane women.

DL cholesterol, often known as “bad cholesterol”, can build up in artery walls and increase heart attack risk.

The research team from Arizona State University had expected different results given the Tsimane’s unusually healthy cardiovascular systems and lifestyle.

Madeleine Getz is a PhD student in global health at ASU’s School of Human Evolution and Social Change and lead author.

She said: “While we have good data from industrialised populations, to our knowledge, nobody had looked at this relationship in a non-industrial, highly active population like the Tsimane before.

“To see these risk factors increase after menopause in this population, despite their incredibly low levels of heart disease, was unexpected.”

The Tsimane live a traditional hunter-farmer lifestyle with diets free of processed foods and very high physical activity, averaging 15,000 to 20,000 steps a day.

Previous studies have shown they have the lowest dementia rates and healthiest hearts of any population studied.

Despite their lifestyle, the cholesterol rise after menopause mirrored that seen in industrialised nations, though at much lower levels.

The increases were two to seven times smaller than those recorded in the US and UK.

“This suggests that these increases in cholesterol around menopause may be a human universal, no matter how or where we live,” Getz said.

Benjamin Trumble, senior author and professor at ASU’s School of Human Evolution and Social Change, co-directs the Tsimane Health and Life History Project, which has worked with the community for more than 20 years.

“Working with populations like the Tsimane allows us to see global variation in both menopause and human health,” Trumble said.

“The findings here suggest that menopause is associated with increased risk factors for heart disease, even in the population with the healthiest hearts in the world.

“That suggests that post-menopausal increases in heart disease may be a human universal, and part of our underlying physiology regardless of lifestyle choices.”

The findings indicate that hormonal changes during menopause affect cardiovascular health regardless of lifestyle.

In industrialised nations, women face increased heart disease risk after menopause, when oestrogen levels fall.