Fewer Than 1 in 4 Women Maintain Optimal CV Health in Menopause: Daily Dose

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On August 4, 2025, we reported on a study published in Menopause that assessed cardiovascular health status as measured by Life’s Essential 8 (LE8) in midlife women in the US.

The study

Researchers analyzed health data collected from 2924 midlife women (mean age, 46 years) who participated in the Study of Women’s Health Across the Nation (SWAN), an ongoing, longitudinal, multisite, multiethnic study that began in 1996. They compared women's LE8 scores at baseline to their to their evolving health trajectories over time, from subclinical cardiovascular disease measures (eg, increased carotid-artery thickness) to cardiovascular events (eg, heart attacks and strokes) to all-cause mortality. They also analyzed the impact of each of the individual LE8 components: nutrition, physical activity, smoking abstinence, sleep, body mass index, blood lipids, blood sugar and blood pressure.

The findings

Investigators reported that 21% of participants achieved an ideal LE8 score (80 or greater) during follow-up. Women with higher baseline scores and greater improvements over time in total LE8 metrics had more favorable outcomes across all measures, including subclinical markers such as carotid intima-media thickness and plaque presence and pulse wave velocity. There were 213 CVD events that included myocardial infarction, stroke, heart failure, and revascularization and 161 deaths over a median 19 years of follow-up.

Among individual LE8 components, favorable baseline or improving scores for glucose, blood pressure, and nicotine exposure were consistently associated with reduced risk for all outcomes. Sleep quality also emerged as a notable factor, with better baseline or improved sleep associated with lower risk of CVD events and mortality, although not linked with subclinical measures such as carotid thickness.

Authors' comments

"The prevalence of ideal total LE8 scores remained below 25% among midlife women. Glucose, blood pressure, and nicotine exposure are critical components of associated risks with lower LE8 scores. Midlife sleep quality may uniquely contribute to future event risk."

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