A comparison of endothelial function in Caucasian and Chinese women before and after the menopause.
OBJECTIVE
Arterial endothelial dysfunction is a key atherogenic event that may be related to oestrogen status. We therefore aimed to compare menopause-related changes in endothelial physiology in Chinese and Caucasian females.


METHODS
We studied 40 female subjects; 20 Chinese from a rural region of Southern China (ten premenopausal, aged 20-35 years, and ten postmenopausal, aged 55-66 years), and 20 age-matched Caucasian females from Sydney, Australia. All women had a clinical history, resting blood pressure and fasting lipids measured, and endothelial function assessed. Using high-resolution external vascular ultrasound, brachial artery diameter was measured at rest, after flow increase (causing endothelium-dependent dilatation) and after sublingual glyceryl trinitrate (GTW) (an endothelium-independent dilator).


RESULTS
There was a significant decline in endothelium-dependent dilatation (EDD) comparing Caucasian females from the premenopausal versus postmenopausal groups (8.4+/-2.7% versus 2.7+/-2.9%; P<0.001). In contrast, there was no significant difference in EDD between pre- and postmenopausal Chinese (9.8+/-3.3% versus 8.3+/-1.7%; P=0.22). On multivariate analysis, postmenopausal status was associated with impaired EDD in Caucasian females (P<0.002) independent of serum cholesterol, blood pressure and vessel size. In contrast, EDD in the Chinese females was not significantly influenced by any of these factors. GTW-induced dilatation was also impaired in the older Caucasian females, a finding explained on multivariate analysis by the increased vessel size in this patient group (P=0.03).


CONCLUSIONS
Menopause is associated with impaired arterial endothelial function in Caucasian but not Chinese women. This suggests possible ethnic differences in menopause-related vascular changes.
McCrohon
J A
JA
The Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
Woo
K S
KS
Celermajer
D S
DS
D000328:Adult; D000368:Aged; D044466:Asian People; D001315:Australia; D001794:Blood Pressure; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000502:physiology; D002681:China; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology; D017698:Postmenopause / Q000502:physiology; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology; D014665:Vasodilator Agents / Q000494:pharmacology; D044465:White People
D008055:Lipids; D014665:Vasodilator Agents; D005996:Nitroglycerin