Does reproductive stage impact cardiovascular disease risk factors? Results from a population‐based cohort in Lausanne (CoLaus study)

Raguindin, Peter Francis; Cardona, Isabel; Muka, Taulant; Lambrinoudaki, Ιrene; Gebhard, Cathérine; Franco, Oscar H.; Marques‐Vidal, Pedro; Glišić, Marija

doi:10.1111/cen.14730

Cited by 3 publications

(2 citation statements)

References 57 publications

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“…These results highlight that not only the decrease in oestrogen, but also the increase in FSH with female ageing might play a central role in arterial ageing in postmenopausal females (Waddell et al., 2001 ). A recent analysis of longitudinal data suggests that age rather than reproductive status influences cardiovascular risk factors, which appears in line with our findings (Raguindin et al., 2022 ). In the cerebral vasculature, a greater decline in MCAv across the lifespan has recently been reported in females compared with males, with the speed of decline being highest in females >60 years of age (Alwatban et al., 2021 ).…”

Section: Discussionsupporting

confidence: 93%

Comparison of peripheral and cerebral vascular function between premenopausal, early and late postmenopausal females

Ruediger

Pizzey

Koep

et al. 2023

Experimental Physiology

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New Findings What is the central question of this study?We sought to investigate whether peripheral and cerebrovascular function are impaired in early and late postmenopausal females compared with premenopausal females, while also accounting for nitric oxide and estradiol levels. What is the main finding and its importance?We observed no differences in peripheral vascular and cerebrovascular function between healthy and physically active premenopausal females and early and late postmenopausal females. Our findings contradict previous cross‐sectional observations of vascular and cerebrovascular dysfunction across menopause. Longitudinal studies assessing vascular and cerebrovascular outcomes across the menopausal transition are warranted. Abstract The risk of cardiovascular and cerebrovascular disease increases in ageing females, coinciding with the onset of menopause. Differences in peripheral and cerebrovascular function across menopausal stages, however, are poorly characterized. The aim of this study was to compare peripheral and cerebrovascular function between healthy premenopausal (PRE), early (1–6 years after final menstrual period; E‐POST) and late (>6 years after final menstrual period; L‐POST) postmenopausal females. We also explored the association between reproductive hormones, NO bioavailability and cerebrovascular function. In 39 females (40–65 years of age), we measured arterial stiffness, brachial artery flow‐mediated dilatation, and cerebrovascular reactivity (CVR) to hypercapnia in the middle (MCAv) and internal (ICA) carotid arteries. Follicle‐stimulating hormone, estradiol, progesterone and plasma nitrate and nitrite concentrations were also measured. Years since final menstrual period (PRE, 0 ± 0 years; E‐POST, 3 ± 1 years; L‐POST, 11 ± 4 years; P < 0.001) and estradiol levels (PRE, 145.5 ± 65.6 pg ml−1; E‐POSTm 30.2 ± 81.2 pg ml−1; L‐POST, 7.7 ± 11.3 pg ml−1; P < 0.001) were different between groups. All groups exceeded the guidelines for recommended physical activity. There were no group differences in blood pressure (P = 0.382), arterial stiffness (P = 0.129), flow‐mediated dilatation (P = 0.696) or MCAv CVR (P = 0.442). The ICA CVR blood flow response was lower in PRE compared with L‐POST (26.5 ± 19.2 vs. 47.8 ± 12.6%; P = 0.010), but after adjusting for age these differences were no longer present. Flow‐mediated dilatation (r = 0.313, P = 0.105) and ICA CVR (r = −0.154, P = 0.495) were not associated with the estradiol concentration. There were no associations between the estradiol concentration and NO bioavailability. These results suggest that in healthy, physically active early and late postmenopausal females, vascular and cerebrovascular function is generally well preserved.

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Section: Discussionsupporting

confidence: 93%

Comparison of peripheral and cerebral vascular function between premenopausal, early and late postmenopausal females

Ruediger

Pizzey

Koep

et al. 2023

Experimental Physiology

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“… 166–168 After menopause transition, women experience a worsening in the lipid profile ( Figure 1 ) with increases in total cholesterol, LDL-C, and TG levels potentially contributing to accelerating ASCVD risk. 169 , 170 …”

Section: Cardiovascular Risk Factors In Women: Focus On Lipidsmentioning

confidence: 99%

Women, lipids, and atherosclerotic cardiovascular disease: a call to action from the European Atherosclerosis Society

Roeters van Lennep,

Tokgözoğlu,

Badimon

et al. 2023

European Heart Journal

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Cardiovascular disease is the leading cause of death in women and men globally, with most due to atherosclerotic cardiovascular disease (ASCVD). Despite progress during the last 30 years, ASCVD mortality is now increasing, with the fastest relative increase in middle-aged women. Missed or delayed diagnosis and undertreatment do not fully explain this burden of disease. Sex-specific factors, such as hypertensive disorders of pregnancy, premature menopause (especially primary ovarian insufficiency), and polycystic ovary syndrome are also relevant, with good evidence that these are associated with greater cardiovascular risk. This position statement from the European Atherosclerosis Society focuses on these factors, as well as sex-specific effects on lipids, including lipoprotein(a), over the life course in women which impact ASCVD risk. Women are also disproportionately impacted (in relative terms) by diabetes, chronic kidney disease, and auto-immune inflammatory disease. All these effects are compounded by sociocultural components related to gender. This panel stresses the need to identify and treat modifiable cardiovascular risk factors earlier in women, especially for those at risk due to sex-specific conditions, to reduce the unacceptably high burden of ASCVD in women.

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Does reproductive stage impact cardiovascular disease risk factors? Results from a population‐based cohort in Lausanne (CoLaus study)

Raguindin

Cardona

Muka

et al. 2022

Clinical Endocrinology

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Context Menopause has been associated with adverse cardiovascular disease (CVD) risk profile, yet it is unclear whether the changes in CVD risk factors differ by reproductive stage independently of underlying ageing trajectories. Design The CoLaus study is a prospective population‐based cohort study in Lausanne, Switzerland. Patients We used data from women at baseline and follow‐up (mean: 5.6 ± 0.5 years) from 2003 to 2012 who did not use hormone therapy. We classified women into (i) premenopausal, (ii) menopausal transition, (iii) early (≤5 years) and (iv) late (>5 years) postmenopausal by comparing their menstruation status at baseline and follow‐up. Measurements We measured fasting lipids, glucose and cardiovascular inflammatory markers. We used repeated measures (linear mixed models) for longitudinal analysis, using premenopausal women as a reference category. We adjusted analyses for age, medications and lifestyle factors. Results We used the data from 1710 women aged 35–75 years. Longitudinal analysis showed that the changes in CVD risk factors were not different in the other three menopausal categories compared to premenopausal women. When age was used as a predictor variable and adjusted for menopause status, most CVD risk factors increased, while interleukin‐6 and interleukin‐1β decreased with advancing age. Conclusion The current study suggests that women have a worsening cardiovascular risk profile as they age, and although menopausal women may have higher levels of cardiovascular risk factors compared to premenopausal women at any given time, the 5‐year changes in cardiovascular risk factors may not depend on the reproductive stage.

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Does reproductive stage impact cardiovascular disease risk factors? Results from a population‐based cohort in Lausanne (CoLaus study)

Cited by 3 publications

References 57 publications

Comparison of peripheral and cerebral vascular function between premenopausal, early and late postmenopausal females

Comparison of peripheral and cerebral vascular function between premenopausal, early and late postmenopausal females

Women, lipids, and atherosclerotic cardiovascular disease: a call to action from the European Atherosclerosis Society

Does reproductive stage impact cardiovascular disease risk factors? Results from a population‐based cohort in Lausanne (CoLaus study)

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