title: The perimenopausal atherosclerosis transition:  relationships between calcified and noncalcified coronary, aortic, and carotid atherosclerosis and risk factors and hormone levels.
abstract: OBJECTIVE
  Women of perimenopause age experience an upward transition of cardiovascular risk possibly in association with changing hormonal status. We examined the cross-sectional relationships between the atherosclerotic plaque within the coronary and carotid arteries and aorta and the menopausal hormone levels among asymptomatic perimenopausal women.
  
  
  METHODS
  The Assessment of the Transition of Hormonal Evaluation with Noninvasive Imaging of Atherosclerosis was a prospective substudy of the Prospective Army Coronary Calcium project. We screened 126 asymptomatic perimenopausal women (mean age, 50 y) using contrast-enhanced CT angiography (multidetector CT) and carotid ultrasound. Women had coronary calcium data from 5 to 10 years earlier. The measures included cardiovascular risk factors, serum hormone levels, 64-slice multidetector CT, and carotid ultrasound.
  
  
  RESULTS
  The prevalence of any coronary plaque was 35.5%. The prevalence of noncalcified plaque was 30.2%, and noncalcified plaque was the only manifestation of coronary artery disease in 10.7%. Markers of androgenicity (increased free testosterone and reduced sex hormone-binding globulin) were associated with an increased extent of calcified and noncalcified coronary artery plaque and aortic plaque. However, these relationships were not independent of cardiovascular risk factors. Follicle-stimulating hormone was directly associated with the number of aortic plaques. The levels of estrogen hormones were unrelated to plaque presence or extent.
  
  
  CONCLUSIONS
  Coronary, aortic, and carotid arterial plaque is prevalent in perimenopausal women without cardiac symptoms. The assessment of perimenopausal hormone status was not independently associated with subclinical atherosclerosis beyond standard cardiovascular risk factors.
authors: Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20010, USA.
authors: Jamalah A
authors: JA
authors: Munir
authors: Hongyan
authors: H
authors: Wu
authors: Kelly
authors: K
authors: Bauer
authors: Jody
authors: J
authors: Bindeman
authors: Carole
authors: C
authors: Byrd
authors: Irwin M
authors: IM
authors: Feuerstein
authors: Todd C
authors: TC
authors: Villines
authors: Allen J
authors: AJ
authors: Taylor
mesh_terms: D001011:Aorta / Q000473:pathology*; D050197:Atherosclerosis / Q000453:epidemiology / Q000473:pathology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006728:Hormones / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D047648:Perimenopause / Q000502:physiology*; D058226:Plaque, Atherosclerotic / Q000473:pathology; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D061205:Vascular Calcification / Q000473:pathology*
chemical_list: D006728:Hormones; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D005640:Follicle Stimulating Hormone