We've gotten very good at talking about breast health. We schedule our mammograms, do our self-breast awareness checks, learn our family history, and many of us know what genetic testing is available for hereditary cancers.
Those conversations are important. Please keep having them.
But here's a question worth sitting with: when was the last time your healthcare provider talked to you about your heart?
Cardiovascular disease is the number one cause of death among women, claiming more lives each year than all forms of cancer combined. And yet most of the health conversations women have, and most of what their providers track, center on cancer prevention. The greatest threat to a woman's long-term health gets far less airtime.
Menopause is a chance to change that.
Menopause Is More Than Hot Flashes
When estrogen levels decline, your body undergoes real metabolic changes that can increase cardiovascular risk. Many women start seeing rising LDL cholesterol, more abdominal fat, reduced insulin sensitivity, elevated blood pressure, increased inflammation, and changes in how their blood vessels function.
This doesn't mean heart disease is inevitable. It means now is exactly the right time to pay closer attention.
Why a Standard Cholesterol Panel Isn't Always Enough
Being told "your cholesterol looks normal" feels reassuring. And sometimes it is. But a traditional lipid panel doesn't always tell the complete story.
Advanced cardiovascular testing can catch hidden risk long before any symptoms show up, which means there's actually time to do something about it. Two tests I frequently discuss with patients are ApoB and Lipoprotein(a), also written as Lp(a).
ApoB: A Better Way to See What's Happening
Here's a way to think about it.
Cholesterol is the passenger. The LDL particle is the vehicle. Your standard LDL number tells you how much cholesterol is being carried. ApoB tells you how many vehicles are on the road.
Every LDL particle carries exactly one ApoB protein. The more particles circulating through your bloodstream, the greater the chance that some of them will slip into your artery walls and start contributing to plaque. Research has shown that ApoB is often a better predictor of future cardiovascular events than LDL alone.
So your LDL number can look perfectly normal while your ApoB is quietly telling a different story.
Lipoprotein(a): The Number Most Women Have Never Heard Of
Lp(a) is one of the strongest inherited risk factors for cardiovascular disease, and most people have never had it measured.
Unlike cholesterol, diet and exercise have very little effect on Lp(a). It's determined almost entirely by genetics. About 20% of people have elevated levels, and the vast majority don't know it.
Elevated Lp(a) is associated with increased risk of heart attack, stroke, peripheral artery disease, and calcific aortic valve disease.
The good news is that Lp(a) stays relatively stable throughout your life, so you typically only need to test it once. Knowing your number lets you and your provider take a more targeted approach to managing every other risk factor that is within your control.
Exercise and Nutrition Are Medicine
One of the most powerful things I can offer a patient doesn't come from a prescription pad. It comes from movement and food.
Regular physical activity improves insulin sensitivity, lowers blood pressure, supports healthy cholesterol metabolism, reduces inflammation, preserves muscle mass, supports bone health, improves mood and cognitive function, and meaningfully reduces the risk of heart disease.
For most women, the goal looks something like this:
- At least 150 minutes of moderate-intensity aerobic activity per week (brisk walking, cycling, swimming, dancing, whatever you'll actually do)
- Strength training 2 to 3 times per week to preserve muscle, support bone density, and maintain metabolism
- Daily movement throughout the day, not just a single workout block
- Balance and flexibility work, like yoga or Pilates, to round things out
Nutrition matters just as much. A heart-healthy eating pattern means plenty of colorful vegetables and fruit, whole grains, lean protein including fish and legumes, healthy fats from olive oil, avocados, nuts, and seeds, high-fiber foods to help with cholesterol and blood sugar, and less of the ultra-processed, high-sugar, high-saturated-fat stuff.
These habits don't just help with weight. They change your metabolic health, reduce inflammation, and lower your cardiovascular risk across the board.
Prevention Should Be Personalized
At Milli Health & Wellness, I don't believe in one-size-fits-all prevention. What makes sense for you depends on your age, your medical history, your family history, and your goals.
Depending on those factors, we might discuss advanced testing that gives us a fuller picture, including:
- ApoB
- Lipoprotein(a)
- Advanced lipid testing
- High-sensitivity C-reactive protein (hs-CRP)
- Fasting insulin
- Hemoglobin A1c
- Body composition analysis
- Blood pressure patterns
- Nutrition and lifestyle assessment
These tests let us look beyond a standard cholesterol panel and build a plan that's actually aimed at your long-term health.
The Bottom Line
I've spent much of my career helping women reduce their risk of cancer. That work matters and it will always be part of what I do.
But I also want women to take their hearts just as seriously.
Keep getting your mammograms. Know your family history. And add a few more questions to your list:
Do I know my ApoB? Have I ever had my Lp(a) measured? Am I eating and moving in a way that actually supports my cardiovascular health?
Knowledge is what makes prevention possible. At Milli Health & Wellness, my goal is to help you build lifelong health through evidence-based prevention, advanced testing, and care that's built around you specifically.
Because protecting your heart today is what gives you the chance to feel well for a very long time.
Ready to get a clearer picture of your cardiovascular health? Book your consultation.