heart disease

Sex Hormone Changes Affect Heart Disease Risk in Women

Sex hormone levels in post-menopausal women may increase cardiovascular disease (CVD), coronary heart disease (CHD), and heart failure (HF) risk, according to new research. Results also indicate the need to assess these hormones as “screenable risk factors.”

For their study, the researchers assessed 2834 post-menopausal women participating in the MESA (Multi-Ethnic Study of Atherosclerosis). Participants included in the analysis were free of CVD at baseline in 2000 to 2002 and had testosterone, estradiol, dehydroepiandrosterone, and sex hormone binding globulin (SHBG) levels taken at baseline.

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After about 12 years of follow-up, 283 CVD events, 171 CHD events, and 103 HF events were recorded.

Results from the researchers’ analysis showed that:

  • A higher testosterone:estradiol ratio increased the risk for incident CVD, CHD, and HF events.
  • A higher testosterone level increased the risk for CVD and CHD.
  • A higher estradiol level reduced CHD risk.

Dehydroepiandrosterone and SHBG levels did not affect the risk for CVD, CHD, or HF.

“A woman’s sex hormone levels and ratios of them isn’t something that physicians regularly check,” says Erin Michos, MD, MHS, associate professor of medicine at the Johns Hopkins University School of Medicine and member of the Ciccarone Center for the Prevention of Cardiovascular Disease.2

“Because an imbalance in the proportion of testosterone … to estrogen … may affect heart disease risk, physicians may want to think about adding hormone tests to the toolbox of screenable risk factors, like blood pressure or cholesterol, to identify women who may be at higher risk of heart or vascular disease. But this needs further study.”2

—Amanda Balbi

References:

  1. Zhao D, Guallar E, Ouyang P, et al. Endogenous sex hormones and incident cardiovascular disease in post-menopausal women. J Am Coll Cardiol. 2018;71(22). doi:10.1016/j.jacc.2018.01.083.
  2. Sex hormone levels alter heart disease risk in older women [press release]. Baltimore, MD: Johns Hopkins Medicine; May 29, 2018. https://www.hopkinsmedicine.org/news/media/releases/sex_hormone_levels_alter_heart_disease_risk_in_older_women. Accessed May 30, 2018.