Chrisandra Shufelt, MD, on cardiovascular prevention at menopause

Menopause is an opportune time for cardiovascular prevention, and OB/GYNs, who are often women’s primary healthcare providers, are well positioned to identify the cardiovascular risk factors that rise during the transition, according to Chrisandra L. Shufelt, MD, MS, FACP, MSCP, professor and chair of the division of general internal medicine and associate director of the Women’s Health Research Center at Mayo Clinic in Jacksonville, Florida. Shufelt spoke in an interview at The Menopause Society Annual Meeting 2026 in San Diego, California.

“We know that 6000 women enter menopause every day, so this is an opportunity to evaluate heart health,” Shufelt said. Beyond hormone therapy itself, she said, clinicians should identify the cardiovascular risk factors that increase around menopause, which she described as a real inflection point.

Why menopause is a cardiovascular inflection point

Men develop heart disease about 10 years earlier than women, and when women develop heart disease, it often coincides with menopause, Shufelt said. Beginning about 2 to 3 years before the final menstrual period, cardiovascular risk factors start to increase, and patients may notice rising blood pressure or worsening cholesterol for the first time.

Some of these changes reflect chronological aging, Shufelt said, while many are tied to what she called ovarian aging, which is closely linked to the timing of menopause.

“I want to see you 20, 30, or 40 years from now, heart healthy,” Shufelt said she tells patients, framing the goal as a longer health span, not just a longer lifespan.

What can ob-gyns assess?

Shufelt recommended checking cholesterol annually in women without a primary care doctor and measuring blood pressure properly, giving the patient a few minutes to relax before the reading and encouraging home monitoring.

She also pointed to a shift in body composition at menopause, with a loss of lean muscle mass and increased central weight gain and visceral adiposity that can drive inflammation and dyslipidemia, along with changes in blood sugar that can progress to metabolic syndrome.

These cardiovascular risk factors should factor into annual examinations and decisions about menopausal hormone therapy, alongside considerations such as breast health, Shufelt said.