Khan ZA, et al. - Considering that women after menopausal transition have increased cardiovascular disease (CVD) risk, researchers sought to characterize the influence of menopause on vascular aging by prospective assessment of change in indices of subclinical atherosclerosis across the menopausal transition. In women undergoing the menopausal transition, changes in aortic stiffness were more sensitive measures of perimenopausal vascular aging vs morphological indices of subclinical atherosclerosis. Findings suggest performing serial assessment of such changes may clarify the mechanisms of disease and help to identify women who would benefit from aggressive lifestyle risk factor modification.

Methods

• From SWAN Heart, an ancillary study of SWAN (Study of Women's Health Across the Nation), 411 healthy women were evaluated for subclinical atherosclerosis at baseline and again after an average of 2.3 years.
• Using ultrasound, researchers measured carotid intima-media thickness (cIMT) and aortic pulse wave velocity (aPWV).
• Using computed tomography, they obtained coronary artery calcium (CAC) scores.
• Women were categorized as premenopausal, postmenopausal, or having undergone the transition during follow-up.
• They adjusted analyses of changes for age at baseline and time between scans.

Results

• At baseline, mean age was 51±3 years; transition to menopause was noted in 93 (23%) subjects (Pre-Post); 147 (36%) remained premenopausal (Pre-Pre), while 171 (41%) were postmenopausal at baseline (Post-Post).
• The groups did not differ regarding blood pressure readings, with similar increases noted in cIMT and logCAC+1 from baseline to follow-up.
• Researchers noted higher change in aPWV from baseline to follow-up in Pre-Post (121±23cm/s) vs Pre-Pre (38±250cm/s, p=0.029) and Post-Post (41±228cm/s, p=0.045).