Age-Related Cardiovascular Diseases in Women : The “48-Syndrome”

Introduction: Cardiovascular diseases (CVDs) are a leading cause of mortality globally, with significant gender differences in incidence and outcomes. While men experience a higher incidence, women, especially those undergoing menopausal transition, exhibit greater CVD-related mortality rates. The following opinion report outlines a trend in CVD risk among women aged 48 years, a crucial point of time associated with perimenopausal changes. Despite presenting symptoms such as severe shortness of breath (SOB) and ischemic chest pain, standard diagnostic tests including electrocardiogram (ECG), and coronary angiogram (CA) often yield normal results suggesting a need for improved diagnostic approaches. Discussion: Hormonal fluctuations: particularly relating estrogen, increase the risk of atherosclerosis, arterial stiffness, and dyslipidemia. Additionally, alterations in lipid metabolism, weight gain, central obesity, and insulin resistance during multiple stages of menopause further exacerbate cardiovascular risks. Inflammation and endothelial dysfunction driven by the variation of estrogen concentrations contribute to vascular abnormalities, while psychological health declines: such as stress and anxiety, may aggravate these conditions. Conclusion: This unique age-specific trend of increased CVD risk at age 48 years in women has been termed the “48-Syndrome.” This highlights the importance of early detection and intervention for middle-aged women. Understanding this age-related phenomenon provides a foundation for developing targeted prevention strategies, improving cardiovascular health, and reducing mortality rates in women during this critical life stage.