Sleep is key to menopausal heart health

In the lead-up to World Heart Day (29 September), sleep is emerging as a powerful yet underestimated ally in women’s cardiovascular care, according to a recent review published in Menopause: The Journal of the Menopause Society.

The transition to menopause marks a key time when a woman’s body undergoes complex hormonal shifts along with changes to fat distribution and lipid metabolism, which may increase cardiovascular health risk. This is coupled with significant cellular changes which can impact mitochondrial health.

The heart, being the most energy-demanding organ in the body, depends on mitochondria to generate the energy needed for optimal function. Mitochondrial health is supported by compounds produced in the body such as ubiquinol, which plays a key role in energy production and maintaining oxidative balance in cells. From around the age of 20, natural ubiquinol levels in the body begin to decline — a process accelerated by factors such as oxidative stress and hormonal shifts, potentially impacting cardiovascular resilience.

“Without healthy mitochondria, our hearts simply can’t function at their optimum,” noted expert commentator Dr Ross Walker, one of Australia’s most respected cardiologists. “This makes supporting our mitochondrial function not just an add-on, but a vital component of preventative cardiovascular care, particularly for women in the menopause stage.”

The research, involving nearly 3000 American women tracked over two decades, found that poor sleep during the menopause transition was linked to higher risks of long-term effects of heart health conditions — particularly when combined with high blood pressure and nicotine use. The research further revealed that only 21% of midlife women in the study achieved optimal cardiovascular health scores using the American Heart Association’s Life’s Essential 8 tool, with sleep quality ranking alongside blood glucose, blood pressure and nicotine use as the most important predictors of future heart health.

According to Walker, the study solidifies the important role that sleep plays as a factor in cardiovascular health prevention, with the review suggesting that seven to nine hours of sleep for most adults may contribute to women’s heart health and longevity.

“We have long focused on diet and exercise in cardiovascular prevention, but this study shows sleep is just as critical, especially during the menopause transition,” Walker said.

“By elevating the role of sleep in cardiovascular health and pairing it with proven lifestyle measures such as balanced nutrition, physical activity, blood pressure control, smoking cessation, and nutritional support where necessary, women can take decisive steps towards maintaining vitality and independence as they age.”

Walker’s message for World Heart Day is that women’s heart health is not a niche issue, but a public health and economic imperative.

“We now have compelling evidence that sleep belongs at the top of the checklist for long-term heart health,” he said. “Recognising and addressing the gender gap in cardiovascular care will help ensure women enter later life with well-supported, healthier hearts.”

Image credit: iStock.com/Eva-Katalin