Menopause has been linked to a number of conditions and coronary artery disease (CAD) is one of them. CAD is caused by the narrowing of blood vessels supplying the heart muscle. As estrogen levels drop, so do good HDL cholesterol, but lousy LDL increases. Both of these raise your risk of heart disease (including CAD) to the roof. In addition, estrogen typically relaxes blood vessels during changes in blood pressure, so when it’s not there, vessels get as stiff as your grandfather’s knee. Stiff blood vessels force your heart to pump as if you were constantly sprinting even if you aren’t, so your blood pressure tends to increase (another risk factor for heart disease and CAD). Now, to add icing to the cake, many women get heavier during this time as well, and some develop full-blown type 2 diabetes or metabolic syndrome. However, the ball is in your court. While you cannot prevent your estrogen levels from dropping unless you take medication or HT (hormone therapy, and remember to talk to your doc about taking it with two baby aspirins a day), you can make sure that you are active, eating well, and managing stress. Get those 10,000 steps, stick to the Mediterranean diet, keep your stress in check, and your risk of CAD or other forms of heart disease will go down.