The research says waiting until after menopause to take steps to reduce the risk of a heart attack or stroke is waiting too long.
"What this research tells us is that the time to begin reducing your risk of heart disease is before you actually are at risk. And for women, that means making the appropriate lifestyle and dietary changes prior to when menopause begins," says Carol Derby, study author and an assistant professor of neurology and epidemiology at the Albert Einstein College of Medicine in New York City.
The findings were presented March 7 at the American Heart Association's annual conference on cardiovascular disease, epidemiology and prevention in Miami.
The research involved some 1,300 women between the ages of 42 and 52 who were evaluated for future risk of heart disease. Based on their current status, by the time they turned 55, more than half the women would need some type of lifestyle change or drug therapy to avoid a heart attack or stroke, the researchers projected.
The take-home message, says Derby, is clear: "Women need to recognize that the perimenopausal period is the key time in which to address the issues that increase their risk of heart disease later in life -- and to do so before they reach the point where their age becomes another significant risk factor."
For cardiologist Dr. Dan Fisher of New York University Medical Center, the advice is sound but can be a double-edged sword.
"While it's a good idea to reduce risk factors for heart disease before problems develop, at the same time women should not come away with the idea that they can throw caution to the wind up to age 54 and then suddenly make the appropriate changes, because that's not always going to help," he says.
In reality, Fisher says, most risk factors for heart disease have a cumulative effect. So the earlier you begin to adopt healthy behaviors -- such as quitting smoking, losing weight or keeping a close eye on cholesterol levels -- the better off you'll be.
The new study was based, in part, on the National Cholesterol Education Program Adult Treatment Panel Guidelines. They are part of a system that utilizes a series of risk factors, including age, to determine at what point cholesterol levels require medical intervention to protect against heart disease. That intervention can include drug therapy or lifestyle changes, such as losing weight, or both.
According to the guidelines, the age at which intervention is usually first considered is 55, so the researchers used this year as a criterion in their study as well. Then they looked at the current heart disease risk profiles of the women in the study, who came from five different racial or ethnic groups. Those profiles included current cholesterol levels, blood pressure and amount of body fat, as well as contributing lifestyle factors such as smoking.
"If nothing else about these women would change, we used their current risk profile to project into the future and see how many would fall into the treatment category by the time they turned 55," Derby says.
The end result: The projections showed that if nothing else but age changed, 65 percent of the women would require treatment to avoid serious heart disease. Of that 65 percent, 19 percent were Hispanic; 18 percent were black; 15 percent, white, 8 percent, Japanese; and 5 percent, Chinese.
This information will hopefully help women realize the need to look at themselves and their health risks during the perimenopausal years, and make the changes that can affect their heart disease risk later in life, Derby says.
Fisher agrees, but also suggests that change is needed much earlier. "We need to make reducing the risk for heart disease a lifetime lifestyle, beginning as young as possible," he says.
For tools and a quiz to help you assess your risk of heart disease, visit The American Heart Association. To learn more about women and heart disease, check with the U.S. Centers for Disease Control and Prevention.