title: 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.
abstract: 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.
authors.affiliation: Graduate School of Public Health, University of Pittsburgh, 127 Parran Hall, 130 De Soto Street, Pittsburgh, Pennsylvania 15241, USA. djohnson@edc.pitt.edu
authors.forename: B Delia
authors.initials: BD
authors.lastname: Johnson
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Dwyer
authors.forename: Frank Z
authors.initials: FZ
authors.lastname: Stanczyk
authors.forename: Vera
authors.initials: V
authors.lastname: Bittner
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Berga
authors.forename: Glenn D
authors.initials: GD
authors.lastname: Braunstein
authors.forename: Ricardo
authors.initials: R
authors.lastname: Azziz
authors.forename: YuChing
authors.initials: Y
authors.lastname: Yang
authors.forename: Georgina E
authors.initials: GE
authors.lastname: Hale
authors.forename: C Noel
authors.initials: CN
authors.lastname: Bairey Merz
mesh_terms: 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*