Women live longer than men, and in Chile, a good part of that greater longevity occurs after menopause. According to data from the Department of Health Statistics and Information (DEIS) for 2025, 73% of female deaths occur after age 70 and 51% after age 80.
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It is a change that also forces us to look at women’s health beyond the reproductive stage. And there, the heart occupies an important place.
For a good part of their fertile lives, women have a cardiovascular advantage over men. One of the reasons lies in estrogens, hormones that, among other functions, have favorable effects on blood vessels and cholesterol metabolism. But this protection decreases with menopause.
“In young women, estrogens have a protective effect because they help better manage cholesterol problems and protect blood vessels. When these hormones decrease, cardiovascular risk begins to increase and approaches that of men,” explains Dr. Fernando Lucero, head of the Department of Cardiovascular Diseases at RedSalud.
This does not mean that menopause alone causes a heart attack, or that women are risk-free before it. Hypertension, high cholesterol, diabetes, smoking, obesity, sedentary lifestyle, and family history continue to play a fundamental role throughout life.
“When a young woman has a heart attack, other risk factors generally need to be sought, including some that are not common, such as genetic factors,” explains Lucero. And he adds that hormonal protection is not absolute either: “Estrogens are protective, but if you smoke, are obese, or are diabetic, estrogens will not save you from everything.”
With the decrease in estrogens, changes can occur that favor cardiovascular risk, including alterations in cholesterol levels and body fat distribution. Added to this is that the passage of years itself increases the likelihood of developing hypertension, diabetes, and cardiovascular disease.
Therefore, rather than understanding menopause as the moment when a previously non-existent risk suddenly appears, specialists suggest that it can be an especially important stage to review cardiovascular health and what factors have accumulated over the years.
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There are also specific female health antecedents that can provide clues much earlier. Having had hypertension during pregnancy, gestational diabetes, premature birth, or early menopause has been associated with a higher subsequent cardiovascular risk.
Prevention, therefore, does not begin at age 50. Staying physically active, not smoking, taking care of diet, and regularly monitoring blood pressure, cholesterol, and blood sugar allow for the detection and management of factors that often progress without producing symptoms.
The relevance of these cares takes on another dimension when considering how much women’s lives have extended. In 2025, of the 60,600 women who died in Chile, almost 44 thousand were over 70 years old and more than 30 thousand were over 80.
This means that for many women, menopause does not mark a final stage, but rather the beginning of several decades of life in which preventing chronic diseases becomes increasingly important.
In this scenario, hormone therapy can be an alternative to treat certain symptoms of menopause, but its indication must be evaluated individually considering the age, medical history, and cardiovascular risk of each woman. Currently, it is not recommended to use it solely for the purpose of preventing heart attacks or cardiovascular diseases.
Menopause, then, can also be an opportunity to ask a question that often gets postponed until symptoms appear: how is my heart and what are my own risk factors today?
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