### How Menopause Affects Your Heart Health **Cholesterol Levels:** After menopause, LDL-cholesterol ("bad" cholesterol) tends to increase while HDL-cholesterol ("good" cholesterol) declines, raising the risk of clogged arteries. It's important to get your cholesterol tested every 4 to 6 years, or more often if you're at higher risk. Aim for total cholesterol under 200 mg/dl, LDL less than 100 mg/dl, and HDL levels of 60 mg/dl or higher. **Belly Fat:** Menopause often leads to weight gain in the abdomen, increasing visceral fat, which surrounds internal organs and contributes to high blood pressure, elevated cholesterol, and type 2 diabetes—all risk factors for heart disease. A waist measurement of 35 inches or more indicates extra visceral fat. **Blood Pressure:** Loss of estrogen and aging make blood vessels less flexible, contributing to higher blood pressure. This can lead to heart disease, heart failure, and stroke. Being overweight can also increase blood pressure by putting more stress on the heart. **Hot Flashes:** Fluctuating estrogen levels during perimenopause can cause hot flashes, which are linked to higher blood pressure and cholesterol levels. Frequent or persistent hot flashes may be a risk factor for cardiovascular disease. **Blood Glucose Levels:** While menopause doesn't cause diabetes, there's a link between estrogen loss and rising blood sugar levels. Early menopause increases the risk of type 2 diabetes. High sugar levels damage blood vessels and nerves, increasing the risk of heart attack and stroke. **Health History Matters:** Complications during pregnancy, such as high blood pressure, gestational diabetes, preterm delivery, and pregnancy loss, increase the risk of cardiovascular disease later in life. **Diet and Lifestyle:** A plant-based diet low in saturated fat, sodium, and added sugar helps maintain healthy cholesterol, blood sugar, and blood pressure levels. Regular exercise, resistance training, adequate sleep, stress reduction, and not smoking are also crucial for heart health, especially after menopause.