Ava Durgin is the Assistant Health Editor at mindbodygreen. She is a recent graduate from Duke University where she received a B.A. in Global Health and Psychology. In her previous work, Ava served as the Patient Education Lead for Duke Hospital affiliated programs, focusing on combating food insecurity and childhood obesity.
Image by FatCamera / Istock
August 18, 2025
If you’re navigating menopause or inching closer to it, you’ve probably heard about the hormonal shifts, mood swings, and hot flashes. But what often gets overlooked is something far more serious: your heart.
While menopause is a natural phase of life, research shows it can also mark a turning point for cardiovascular health. In fact, it’s a time when the risk of heart disease, a leading cause of death in women, begins to climb.
Midlife is a window of opportunity for heart health
To better understand how lifestyle habits affect heart health during menopause, researchers looked at nearly 3,000 women going through the transition, with an average age of 46. These women were part of a long-term health study that included participants from diverse backgrounds across the U.S.
The team tracked eight key areas known to impact heart health (blood sugar, blood pressure, cholesterol, diet, physical activity, weight, sleep, and nicotine exposure) using a tool called Life’s Essential 8 (LE8) from the American Heart Association.
Over the years, they monitored how changes in these habits affected real-life outcomes, like heart attacks, strokes, and overall longevity.
And here’s what makes this research especially empowering: it didn’t just focus on those who had perfect health from the start. It showed that even small improvements over time, like better sleep or more movement, can lead to meaningful changes in heart health.
The 4 lifestyle habits that matter most
Blood sugar regulation: High glucose levels can damage blood vessels over time, increasing the risk for heart disease and stroke. Even modest improvements in blood sugar management were linked to better long-term outcomes.
Blood pressure control: High blood pressure remains one of the most consistent predictors of cardiovascular issues. The study showed that keeping blood pressure in check during midlife had a strong protective effect.
Nicotine exposure: Unsurprisingly, smoking or ongoing exposure to nicotine significantly increased cardiovascular risk. Quitting (or never starting) made a meaningful difference.
Sleep quality: Perhaps the most surprising finding? Sleep health emerged as a standout predictor, sometimes even more than blood pressure. Women who slept better had lower risks of heart disease and lived longer, regardless of other factors.
Small changes = big impact
Only about 1 in 5 women in the study met the ideal threshold for overall cardiovascular health. But here’s the silver lining: even women who started off with low scores saw benefits when they improved over time. In other words, you don’t need to be perfect; you just need to make progress.
Monitoring your blood pressure regularly (even at home) and talking to your doctor about any concerns.
Creating a consistent, tech-free bedtime routine to support deeper, more restorative sleep.
If you smoke, seeking out supportive resources to help you quit.
The takeaway
Menopause may bring challenges, but it also brings a unique opportunity. This study is a clear reminder that your choices, especially around sleep, blood sugar, blood pressure, and nicotine, can influence your heart health well into the future.
