title: High prevalence of subclinical atherosclerosis in Brazilian postmenopausal women with low and intermediate risk by Framingham score.
abstract: Cardiovascular diseases are the leading cause of mortality among women in several countries. Early detection of subclinical atherosclerosis (SA) could enable the adoption of preventive measures to avoid cardiovascular events. This study aimed to determine the prevalence of SA in Brazilian asymptomatic postmenopausal women in Framingham Risk Score (FRS) low and intermediate groups. Computed tomography (CT) and ultrasound (US) scans were performed in 138 asymptomatic postmenopausal women (56.1 ± 4.9 years of age) to survey for coronary artery and aortic calcification (CT scan) and assess carotid intima-media thickness (CIMT) and identify carotid plaques (US). The mean FRS was 2.64 ± 2.13 %. The prevalence of increased CIMT, carotid plaques, increased CIMT and/or plaques, coronary artery calcification (CAC) >0 and aortic calcification (AC) were, respectively, 45.7, 37.7, 62.3, 23.9 and 45.7 %. Normal imaging tests were found in 22.4 %. SA, defined as at least one abnormal imaging test, was associated with age, FRS, waist-to-rip ratio, systolic and diastolic blood pressure, HDL-c and ApoA1 levels, and ApoA1/ApoB ratio. In logistic regression, SA was associated with higher age (OR 1.108, 95 % CI 1.010-1.215, p = 0.029) and lower ApoA1 levels (OR 0.979, 95 % CI 0.960-0.998, p = 0.029). SA was prevalent in Brazilian postmenopausal women with low and intermediate risk groups (FRS) and was associated with higher age and lower levels of ApoA1. Carotid atherosclerosis was the most common presentation of SA in this group.
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil. anapetisco@outlook.com.
authors.forename: Ana Claudia Gomes Pereira
authors.initials: AC
authors.lastname: Petisco
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors.forename: Jorge Eduardo
authors.initials: JE
authors.lastname: Assef
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: de Jesus
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors.forename: Mohamed Hassan
authors.initials: MH
authors.lastname: Saleh
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors.forename: Jose Eduardo Martins
authors.initials: JE
authors.lastname: Barbosa
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors.forename: David
authors.initials: D
authors.lastname: Costa de Souza Le Bihan
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors.forename: Ibraim Masciarelli França
authors.initials: IM
authors.lastname: Pinto
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors.forename: Simone
authors.initials: S
authors.lastname: Rolim Fernandes Fontes Pedra
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors.forename: Rodrigo Bellio de Mattos
authors.initials: RB
authors.lastname: Barretto
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors.forename: Amanda Guerra de Moraes Rego
authors.initials: AG
authors.lastname: Sousa
mesh_terms: D000328:Adult; D000368:Aged; D001018:Aortic Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001027:Aortography / Q000379:methods; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D001938:Brazil / Q000453:epidemiology; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D017698:Postmenopause / Q000097:blood; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D061205:Vascular Calcification / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D049629:Waist-Hip Ratio
chemical_list: D015415:Biomarkers; D008055:Lipids
keywords: Atherosclerosis; Cardiovascular diseases; Imaging; Menopause; Risk assessment