title: Subclinical atherosclerosis in menopausal women with low to medium calculated cardiovascular risk.
abstract: BACKGROUND
  The menopausal status is closely related with cardiovascular disease (CVD). Nevertheless, it is still not included in risk stratification by total cardiovascular risk estimation systems. The present study aimed to evaluate the extent of subclinical vascular disorders in young healthy postmenopausal women.
  
  
  METHODS
  This cross-sectional study consecutively recruited 120 healthy postmenopausal women without clinically overt CVD or diabetes, aged 41-60 years and classified as not high-risk by the Heartscore (<5%). In addition to risk factors used for Heartscore calculations, years since menopause and associated risk factors (triglycerides (range 37-278 mg/dl), waist circumference (62-114 cm), fasting blood glucose (69-114 mg/dl) and HOMA-IR (0.44-5)) were also assessed. Carotid-femoral pulse wave velocity, carotid and femoral intima-media thickness in the abnormal range as well as atheromatous plaques both in carotid and femoral arteries were used to define the presence of subclinical atherosclerosis.
  
  
  RESULTS
  Subclinical atherosclerosis and the presence of at least one plaque were identified in 55% and 28% of women, respectively. Subjects with subclinical atherosclerosis had higher age, years since menopause, HOMA-IR and blood pressure. By multivariate analysis years since menopause and systolic blood pressure independently determined subclinical atherosclerosis while 79% of intermediate-risk women (Heartscore 2-4.9%) being in menopause for at least 4 years would be reclassified to a higher risk for the presence of atherosclerosis.
  
  
  CONCLUSIONS
  Subclinical atherosclerosis was highly prevalent in postmenopausal women with low to medium Heartscore. Thus our data suggest that menopausal status and associated risk factors should be additionally weighted in risk calculations, regarding primary prevention strategies in this population.
authors: 2nd Department of Obstetrics and Gynecology, 76 Vas. Sofias Ave., University of Athens, Aretaieio Hospital, Athens, Greece.
authors: Irene
authors: I
authors: Lambrinoudaki
authors: Eleni
authors: E
authors: Armeni
authors: Georgios
authors: G
authors: Georgiopoulos
authors: Maria
authors: M
authors: Kazani
authors: Evangelia
authors: E
authors: Kouskouni
authors: Maria
authors: M
authors: Creatsa
authors: Andreas
authors: A
authors: Alexandrou
authors: Stylianos
authors: S
authors: Fotiou
authors: Christos
authors: C
authors: Papamichael
authors: Kimon
authors: K
authors: Stamatelopoulos
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors