title: Carotid artery distensibility and hormone therapy and menopause: the Los Angeles Atherosclerosis Study.
abstract: OBJECTIVE
  Observational studies have suggested that arterial distensibility decreases during menopause; however, its relationship with hormone therapy use remains controversial. We prospectively studied distensibility and hormone therapy use at different menopause stages.
  
  
  METHODS
  One hundred sixty-one women (aged between 42 and 61 y) without cardiovascular disease underwent carotid artery measurements by ultrasound to calculate distensibility index at baseline and 3 years later. Menopause stage was classified at each visit as premenopausal, perimenopausal, and postmenopausal. Across 3 years of prospective observation, women were classified as remaining premenopausal, remaining postmenopausal, or transitioning (defined as change from premenopausal to perimenopausal, from premenopausal to postmenopausal, from perimenopausal to perimenopausal, or from perimenopausal to postmenopausal).
  
  
  RESULTS
  Distensibility declined across time at all menopause stages (P < 0.0001). Compared with postmenopausal women, premenopausal and transitioning/no hormone therapy women had more than twice the decline in distensibility index (P = 0.06 and P = 0.016, respectively), whereas transitioning/hormone therapy women did not differ in distensibility decline (P = 0.28). In a multivariate model, change in systolic blood pressure (P < 0.0001) and change in pulse pressure (P = 0.004) were independent predictors of distensibility index change and served as effect modulators. In an adjusted model, women in the premenopausal and transitioning/no hormone therapy groups had a significantly faster decline in distensibility index (P = 0.002 and P = 0.001, respectively) compared with postmenopausal women, whereas the transitioning/hormone therapy group did not (P = 0.21).
  
  
  CONCLUSIONS
  These findings confirm that the menopausal transition is associated with reduced vascular compliance. Hormone therapy is associated with better arterial distensibility only during the menopausal transition. Additional prospective studies are needed to confirm these findings and to determine whether hormone therapy use beyond the menopausal transition is related to distensibility.
authors: 1Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 2University of Pittsburgh, Pittsburgh, PA 3Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL 4Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC 5Departments of Obstetrics and Gynecology and Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 6Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors: Chrisandra
authors: C
authors: Shufelt
authors: Omeed
authors: O
authors: Elboudwarej
authors: B Delia
authors: BD
authors: Johnson
authors: Puja
authors: P
authors: Mehta
authors: Vera
authors: V
authors: Bittner
authors: Glenn
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authors: Braunstein
authors: Sarah
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authors: Berga
authors: Frank
authors: F
authors: Stanczyk
authors: Kathleen
authors: K
authors: Dwyer
authors: C Noel Bairey
authors: CN
authors: Merz
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002339:Carotid Arteries / Q000648:ultrastructure*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors