Heart health after menopause

Your blood pressure and cholesterol can be high even when you feel well. Around menopause, it’s worth asking about heart-health checks. You can ask about everyday support as well as treatment for hot flushes.

Risk changes through midlife

The Office on Women’s Health explains that lower oestrogen and changes that come with age can raise the risk of heart disease and stroke. This evidence is about women and reflects both menopause and getting older.

Your own risk also depends on things like smoking, blood pressure, cholesterol and family history. You can change some of these, but not others. A review looks at more than whether your periods have stopped. It works out what support could help you.

Checks to discuss with your clinician

In England, the NHS Health Check is offered to eligible adults aged 40 to 74 every 5 years. Some health conditions mean you can’t have it. If you already have a condition such as heart disease, diabetes or high blood pressure, your care team can explain your regular check-ups instead.

The check usually measures your blood pressure and cholesterol, and may include a blood sugar test. Expect questions about the health of close relatives, smoking, alcohol and how active you are. If you think you’re eligible but haven’t been invited, contact your GP practice.

The US doesn’t have this NHS invitation system. The Office on Women’s Health recommends blood pressure and cholesterol checks, with other tests depending on your health. Ask your clinician which checks you need and how often. Elsewhere in the UK or in other countries, ask about the local service.

Make prevention practical

Being active helps your heart, and stopping smoking reduces harm to your health. The Office on Women’s Health suggests things like brisk walking and getting support to quit smoking. Pick a starting point that fits your life, and ask for help if a change feels hard.

A health review can also cover what you eat, salt and alcohol, and support to manage cholesterol. After a check, the NHS may refer you to local exercise or stop-smoking services. Ask for a follow-up plan so you know what you’re working towards.

HRT treatment is a separate decision

NICE recommends HRT as an option for hot flushes and sweats. But it says not to offer HRT just to prevent heart and blood vessel disease. Your age, situation and risk factors all matter when choosing treatment for symptoms. Ask how the treatment you’re offered is likely to help you.

In the US, the USPSTF recommends against systemic hormone therapy (hormones that work through the whole body) to prevent long-term conditions after menopause. That advice is for people without symptoms who are thinking about treatment for prevention. It doesn’t cover treating menopause symptoms, or people whose menopause came early or followed surgery.

This advice changed recently. In February 2026, the FDA approved changes to HRT labels. These included removing statements about heart and blood vessel risk from the boxed warning on a first group of products. That label change and the prevention advice answer different questions. Talk to your prescriber about the current information for your treatment.

When symptoms need help

Call 999 now in the UK, 911 in the US, or your local emergency number if you have chest pain that feels tight or squeezing, or spreads to your arms, neck or jaw. Don’t drive yourself to hospital. US guidance says to call even if you’re not sure it’s a heart attack.

Heart attack symptoms can also include breathlessness, feeling sick, back or jaw pain and extreme tiredness. If you think you’re having a heart attack, call emergency services now. Don’t wait for a menopause appointment or a routine health check.

For a routine talk about prevention, book with your GP in the UK or your doctor in the US or elsewhere. Bring any past results, your medicine list and the questions you want answered about heart checks or HRT.