Menopause is a profound time in women’s lives that fails to get the attention that it deserves. Aside from the telltale signs of night sweats and hot flashes, fluctuating hormone levels and changes in menstrual patterns, women going through menopause are also at a significantly increased risk for heart disease. In fact, postmenopausal women have up to a 2.6 times higher risk of cardiovascular events, including heart attack, than premenopausal women of the same age. Considering that heart disease is the leading cause of death for women in the U.S., that makes menopause a crucial time to focus on women’s heart health. Unfortunately, we do not do enough to support women going through menopause. That’s why Hello Heart has launched it’s menopause feature to support and empower women going through menopause to take action to support their heart health. The same way women who turn 40 take steps to lower their risk of breast cancer by getting regular mammograms, women going through menopause can take steps to lower their risk of heart disease by tracking their blood pressure and cholesterol, and using this data to get the right treatment.
Let’s first start with some definitions. Perimenopause, or menopause transition, refers to the time before menopause when women experience changes in their pattern of menstruation and changes in hormone levels. This usually begins between ages 45 and 55, but can start as early as the mid-30s. Menopause is diagnosed after a woman has gone 12 months without a menstrual period, and the average age for menopause in the US is 52. After menopause, estrogen levels drop significantly.
The changes in hormone levels mean that women in perimenopause and menopause commonly experience symptoms like hot flashes, night sweats, mood and cognitive changes, genitourinary symptoms, and irregular periods. In fact, three-quarters of women going through menopause have symptoms, with a quarter of women having severe symptoms. What we do not hear enough about is the fact that lower levels of estrogen also mean that postmenopausal women are at an increased risk for heart disease. Estrogen is protective in younger women, and keeps the cardiovascular system healthy by stabilizing blood pressure, lowering LDL (“bad”) cholesterol, lowering triglycerides (a type of fat in the blood), and increasing HDL (“good”) cholesterol. When estrogen levels drop after menopause, women have worsening risk factors for heart disease, including increased blood pressure, increased total cholesterol, increased LDL cholesterol, increased triglycerides, and decreased HDL cholesterol. Symptoms and heart risk are related, as hot flashes and trouble sleeping are associated with worse heart risk.
If that wasn’t enough for women to deal with, there is also the reality that we, as a society, do not do enough to support them. For example, there is a general lack of awareness of the importance of heart risk in women, even among women themselves. The healthcare system also provides inadequate treatment for women with heart disease, best seen by looking at the way we treat women with heart attacks. Finally, women going through menopause must deal with stigma, embarrassment, and a lack of clear and high-quality information.
We need to do better, especially since most cardiac and stroke events can be prevented through education, controlling risk factors like high blood pressure, and with healthy lifestyle changes like moving more and eating better. And for that reason, Hello Heart is proud to launch our menopause feature.
The goal of the feature is to provide education, support, and tools for women going through menopause so that they can better understand how menopause affects their heart health, and learn what they can do about it. Through the Hello Heart app, women will receive credible information about menopause and the hormonal changes that can contribute to symptoms and increased heart risk. Women will also have the option to review actionable insights and advice around managing symptoms and reducing heart risk, for example, re-checking cholesterol levels for women at increased risk or making dietary changes that might help with hot flashes. All of this content will be contextual, so that women will understand why they are seeing it, and will know that other women are dealing with similar issues. Women will also have the option to customize their in-app experience depending on where they are in their menopause journey. Taken together, the feature should help to replace the shame women feel around menopause with high-quality and personalized information, and empower women to take action on their heart health and manage their symptoms.
Menopause is a crucial time to focus on women’s heart health given the accelerating risk for heart disease and worsening heart risk factors. We don’t do enough to support women going through menopause, but Hello Heart’s new menopause feature will change that by supporting and empowering women to take action to support their heart health. This means women going through menopause can take steps to lower their risk of heart disease by tracking their blood pressure and cholesterol, the same way women take steps to lower their risk of breast cancer by getting mammograms.
Hello Heart is not a substitute for professional medical advice, diagnosis, and treatment. You should always consult with your doctor about your individual care.
1. Gazit T, Gutman M, Beatty AL. Assessment of Hypertension Control Among Adults Participating in a Mobile Technology Blood Pressure Self-management Program. JAMA Netw Open. 2021;4(10):e2127008, https://doi.org/10.1001/jamanetworkopen.2021.27008. Accessed October 19, 2022. (Some study authors are employed by Hello Heart. Because of the observational nature of the study, causal conclusions cannot be made. See additional important study limitations in the publication. This study showed that 108 participants with baseline blood pressure over 140/90 who had been enrolled in the program for 3 years and had application activity during weeks 148-163 were able to reduce their blood pressure by 21 mmHg using the Hello Heart program.) (2) Livongo Health, Inc. Form S-1 Registration Statement. https:/www.sec.gov/Archives/edgar/data/1639225/000119312519185159/d731249ds1.htm. Published June 28, 2019. Accessed October 19, 2022. (In a pilot study that lasted six weeks, individuals starting with a blood pressure of greater than 140/90 mmHg, on average, had a 10 mmHG reduction.) NOTE: This comparison is not based on a head-to-head study, and the difference in results may be due in part to different study protocols.
2. Validation Institute. 2021 Validation Report (Valid Through October 2022). https://validationinstitute.com/wp-content/uploads/2021/10/Hello_Heart-Savings-2021- Final.pdf. Published October 2021. Accessed October 19, 2022. (This analysis was commissioned by Hello Heart, which provided a summary report of self-fundedemployer client medical claims data for 203 Hello Heart users and 200 non-users from 2017-2020. Findings have not been subjected to peer review.)