The relationship of menopausal status and rapid menopausal transition with carotid intima-media thickness progression in women: a report from the Los Angeles Atherosclerosis Study.
BACKGROUND
The onset of menopause has been associated with an increase in cardiovascular risk factors. However, little information is available about the rapidity of the menopausal transition and its relationship to the development of preclinical cardiovascular disease (CVD).


OBJECTIVE
Our objective was to assess whether the rate of carotid intima-media thickness (cIMT) progression over time differs according to 1) menopausal status and 2) rapidity of the menopausal transition.


METHODS
We evaluated 203 community-based women aged 45-60 yr without previously diagnosed CVD who underwent three repeated measurements of cIMT as a measure of preclinical CVD over 3 yr. Menopausal status was ascertained at each visit based on menstrual cycle parameters and reproductive hormone profiles. Of these, 21 remained premenopausal, 51 transitioned, and 131 were postmenopausal throughout the observation period.


RESULTS
Age-adjusted cIMT progression rates were similar among premenopausal, transitioning, and postmenopausal women. In the 51 transitioning women, age was not related to rate of cIMT progression. However, the rapidity of menopausal transition was related to cIMT progression: women transitioning from pre- to postmenopause within the 3-yr period had a higher rate of cIMT progression compared with women with a slower transition. Statistical adjustments for the significant covariates of systolic blood pressure, body mass index, race, cigarette smoking, or hormone therapy use did not alter the findings.


CONCLUSIONS
Among healthy women undergoing repeated cIMT measurement, a more rapid menopausal transition was associated with a higher rate of preclinical CVD progression measured by cIMT. Further work is needed to explore potential mechanisms of this effect.
Johnson
B Delia
BD
Graduate School of Public Health, University of Pittsburgh, 127 Parran Hall, 130 De Soto Street, Pittsburgh, Pennsylvania 15241, USA. djohnson@edc.pitt.edu
Dwyer
Kathleen M
KM
Stanczyk
Frank Z
FZ
Bittner
Vera
V
Berga
Sarah L
SL
Braunstein
Glenn D
GD
Azziz
Ricardo
R
Yang
YuChing
Y
Hale
Georgina E
GE
Bairey Merz
C Noel
CN
D050197:Atherosclerosis / Q000209:etiology / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000209:etiology* / Q000473:pathology*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D015141:Los Angeles; D008297:Male; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D009929:Organ Size; D012306:Risk; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*