La menopausia como factor de riesgo para el infarto agudo de miocardio

Resumen

Objective: To analyze how hormonal and metabolic changes associated with menopause influence the incidence and prognosis of acute myocardial infarction in women. Literature review: Cardiovascular diseases remain the leading cause of mortality worldwide, with acute myocardial infarction being one of the most severe manifestations. During the reproductive phase, women experience cardiovascular protection attributed to estrogen, which helps preserve endothelial function, regulate lipid profiles, and reduce inflammation. With the onset of menopause, there is an abrupt decline in hormonal levels, a loss of estrogenic protection, and a significant increase in cardiovascular risk, which becomes comparable to that of men. Furthermore, menopause is associated with classical risk factors such as central obesity, insulin resistance, arterial hypertension, and atherogenic dyslipidemia, all of which heighten vulnerability to infarction. Final considerations: Hormone replacement therapy (HRT) plays an ambiguous role: when initiated early, within the so-called “window of opportunity,” it may improve vascular function, lipid profile, and reduce the risk of cardiac events; however, when used later, it is associated with an increased risk of thromboembolism and stroke. Therefore, HRT should be prescribed individually and only after a thorough assessment of cardiovascular risk.