Hidden heart threats women face through life

Participants during the Inaugural African Women's Heart Health Symposium held in Nairobi on October 24, 2026. [Benard Orwongo Standard]

Cardiovascular disease remains one of the leading threats to women’s health, yet its warning signs often go unnoticed as risk factors accumulate silently. Pregnancy complications, diabetes, obesity and hormonal changes during menopause can increase a woman’s vulnerability, making early detection and preventive care critical.

As women approach middle age, the transition into menopause presents an important opportunity to reassess cardiovascular health. Declining oestrogen levels, changes in cholesterol, shifting body fat distribution and alterations in metabolism can increase the risk of heart disease, often without obvious symptoms.

These issues were discussed at the inaugural African Women’s Heart Health Symposium in Nairobi on October 24 at Villa Rosa Kempinski. Specialists examined cardiovascular risks across a woman’s life, from pregnancy and reproductive health to menopause and older age.

Dr Mzee Ngunga, president of the Kenya Cardiac Society, said early menopause and loss of ovarian function can significantly increase cardiovascular risk. He also highlighted the role of autoimmune conditions.

“Entering menopause or losing ovarian function early substantially raises cardiovascular risk. Women have a much higher prevalence of autoimmune disorders such as lupus or rheumatoid arthritis, which accelerate arterial plaque build-up,” he said.

Obesity can increase cardiovascular risk because excess body fat contributes to insulin resistance, high blood pressure and abnormal cholesterol levels, placing additional strain on the cardiovascular system.

However, weight alone does not determine whether a woman will develop heart disease. Blood pressure, blood glucose, cholesterol, family history, smoking, physical activity and existing medical conditions also influence individual risk.

Diabetes, polycystic ovary syndrome (PCOS) and thyroid disorders may further complicate the picture. PCOS is associated with metabolic abnormalities, including insulin resistance, while thyroid disorders can affect cholesterol levels and heart function.

Specialists emphasised early recognition and management of these conditions as part of a woman’s overall health. Cardiovascular risks can emerge during pregnancy, long before menopause begins.

Participants during the Inaugural African Women's Heart Health Symposium held in Nairobi on October 24, 2026. [Benard Orwongo Standard]

Dr Nelly Bosire, an obstetrician and gynaecologist, addressed adverse pregnancy outcomes as potential indicators of long-term cardiovascular risk. “Women who experience pre-eclampsia, gestational hypertension or gestational diabetes have an increased risk of developing cardiovascular disease later in life. Their pregnancy history should therefore remain part of their medical record and inform future preventive care.”

Bosire said maternity services should be linked to long-term cardiovascular monitoring, rather than treating pregnancy complications as problems that end with delivery.

Menopause also brings changes that can influence cardiovascular health. Oestrogen contributes to bone maintenance and cholesterol regulation. During perimenopause, hormone levels fluctuate before declining as women transition into menopause.

These changes may coincide with rising cholesterol, shifts in body fat distribution and an increased likelihood of developing cardiovascular risk factors. However, declining oestrogen does not mean every woman will develop heart disease. Age, blood pressure, diabetes, family history and lifestyle also contribute to risk.

Declining oestrogen also contributes to bone loss, increasing the risk of osteoporosis and fractures. Women may experience hot flushes, night sweats, disrupted sleep, vaginal dryness and mood changes.

Menopause should therefore be approached as a whole-person health issue rather than solely a reproductive milestone.

Regular physical activity, a balanced diet, avoiding tobacco and routine health checks can help reduce cardiovascular risk. Blood pressure, cholesterol and blood glucose assessments can identify problems before complications arise. Women with a history of pregnancy-related hypertension, diabetes or other relevant conditions should discuss follow-up with their healthcare providers.

The symposium’s wider message was that women’s cardiovascular health cannot be separated from reproductive, hormonal and metabolic health. Identifying risk factors early and ensuring continuity of care from pregnancy through menopause and beyond can help women make informed decisions and reduce preventable complications.

Routine reviews are particularly important for women with multiple risk factors, a family history of heart disease or a history of complications during pregnancy and as they grow older.