title: Self-reported menopausal symptoms, coronary artery calcification, and carotid intima-media thickness in recently menopausal women screened for the Kronos early estrogen prevention study (KEEPS).
abstract: OBJECTIVE
  To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Multicenter, randomized controlled trial.
  
  
  METHODS
  Recently menopausal women (n = 868) screened for the Kronos Early Estrogen Prevention Study (KEEPS).
  
  
  METHODS
  None.
  
  
  METHODS
  Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum E2 levels, and measures of atherosclerosis were assessed. Atherosclerosis was quantified using coronary artery calcium (CAC) Agatston scores (n = 771) and carotid intima-media thickness (CIMT). Logistic regression model of menopausal symptoms and E2 was used to predict CAC. Linear regression model of menopausal symptoms and E2 was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, E2, CAC, and CIMT were assessed.
  
  
  RESULTS
  In early menopausal women screened for KEEPS, neither E2 nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations and depression approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E2 predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness, and E2.
  
  
  CONCLUSIONS
  Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine whether baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease.
  
  
  BACKGROUND
  NCT00154180.
authors: Program in Reproductive and Adult Endocrinology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA. wolffe@mail.nih.gov
authors: Erin Foran
authors: EF
authors: Wolff
authors: Yunxiao
authors: Y
authors: He
authors: Dennis M
authors: DM
authors: Black
authors: Eliot A
authors: EA
authors: Brinton
authors: Mathew J
authors: MJ
authors: Budoff
authors: Marcelle I
authors: MI
authors: Cedars
authors: Howard N
authors: HN
authors: Hodis
authors: Rogerio A
authors: RA
authors: Lobo
authors: Joann E
authors: JE
authors: Manson
authors: George R
authors: GR
authors: Merriam
authors: Virginia M
authors: VM
authors: Miller
authors: Fredrick
authors: F
authors: Naftolin
authors: Lubna
authors: L
authors: Pal
authors: Nanette
authors: N
authors: Santoro
authors: Heping
authors: H
authors: Zhang
authors: S Mitchell
authors: SM
authors: Harman
authors: Hugh S
authors: HS
authors: Taylor
mesh_terms: D000328:Adult; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D018450:Disease Progression; D004414:Dyspareunia / Q000150:complications / Q000188:drug therapy; D015914:Estrogen Replacement Therapy / Q000379:methods*; D004967:Estrogens / Q000008:administration & dosage / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D019584:Hot Flashes / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008137:Longitudinal Studies; D008593:Menopause / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications / Q000188:drug therapy; D011237:Predictive Value of Tests; D057566:Self Report
chemical_list: D004967:Estrogens