Increased risk of atherosclerosis in women after the menopause

Witteman, J.C.M.; Grobbee, D. E.; Kok, F.J.; Hofman, Albert; Valkenburg, H.A.

doi:10.1016/0378-5122(89)90244-2

Cited by 56 publications

(62 citation statements)

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“…24,34 Oestrogens may also influence the viscoelastic properties of the arterial wall by changing the relative proportions of collagen and elastin, 35 by inhibition of smooth muscle cell proliferation, or by the prevention of atherosclerotic stiffening. 36 Menopause does not occur as a sudden event but as a continuous transition from a regular menstrual cycle to ovarian failure. 2 Thus, estrogen deficiency or hormonal replacement therapy may initially induce functional alterations, while structural vascular changes are more likely to contribute to long-term effects.…”

Section: Discussionmentioning

confidence: 99%

“…Initially, the sample had been stratified by sex and age (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59), у60 years), in an attempt to recruit the same number of subjects in each stratum. Households were identified from population registries as persons who shared the same address.…”

Section: Study Populationmentioning

confidence: 99%

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Menopause and the characteristics of the large arteries in a population study

et al. 2001

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In previous cross-sectional and longitudinal population studies, we found that the slope of systolic pressure on age was steeper in postmenopausal than in premenopausal women. We hypothesised that this observation could be due to a specific effect of menopause on the elasticity of the large arteries. We investigated 315 randomly selected women, aged 30 to 70 years. Based on 5.2 years of follow-up, 166 women were premenopausal and 149 menopausal (44 reaching menopause and 105 postmenopausal). These women were matched on age and body mass index with 315 men. We used a walltracking ultrasound system to measure the diameter, compliance and distensibility of the brachial and the common carotid and femoral arteries as well as carotidfemoral pulse wave velocity. Pulse pressure was determined from 24-h blood pressure recordings. Both in menopausal women (r = 0.37; P Ͻ 0.001) and in matching male controls (r = 0.16; P = 0.04), pulse pressure widened with increasing age. The slope of the 24-h pulse pressure on age was steeper in menopausal

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Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Menopause and the characteristics of the large arteries in a population study

et al. 2001

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“…5 The extent of aortic calcified plaque as measured by routine x-rays in either the thoracic or abdominal aorta increases with age in women from the premenopause through the postmenopause. 8,9 Women who had undergone a bilateral …”

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confidence: 99%

Coronary and Aortic Calcification Among Women 8 Years After Menopause and Their Premenopausal Risk Factors

Kuller

Matthews

Sutton-Tyrrell

et al. 1999

ATVB

133

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Abstract-In the Healthy Women Study, the relationship between cardiovascular risk factors measured premenopausally at age 48, use of hormone therapy, and coronary and aortic calcification at age 58 were evaluated among 169 women. Approximately 63% of women had no coronary calcification, but only 29% had no aortic calcification. Coronary calcification and aortic calcification were positively correlated with each other. There was a very strong association between low density lipoprotein cholesterol (LDL-C) level and coronary calcification. Among women with premenopausal levels of LDL-C Ͻ100 mg/dL, only 9% had a coronary calcium score Ն101 compared with 30% of women with an LDL-C Ͼ160 mg/dL. Only 5% of women with a high density lipoprotein cholesterol (HDL-C) level Ͼ60 mg/dL had high coronary scores. The level of HDL 2 -C was especially strongly inversely related to coronary calcium scores. Cigarette smoking was a very important determinant of both high aortic and high coronary calcium scores. Other risk factors associated with greater coronary calcium were higher systolic blood pressure, triglycerides levels, and blood glucose. Use of hormone replacement therapy was associated with less coronary calcium (NS). For both hormone replacement therapy users and nonusers, the levels of LDL-C and HDL-C measured premenopausally were predictors of coronary and aortic calcium scores. Thus, risk factors evaluated premenopausally are powerful predictors of coronary and aortic calcification, a marker of atherosclerosis, measured 8 years after menopause, 11 years later in these women. Key Words: coronary artery disease Ⅲ coronary calcification Ⅲ lipids Ⅲ smoking Ⅲ hormone replacement therapy T he development of new techniques to measure the extent of subclinical cardiovascular disease, such as carotid duplex scanning and electron beam CT (EBCT), has provided important new approaches to study the relationship of risk factors and cardiovascular disease. In this article, we report the relationship between cardiovascular risk factors measured premenopausally and coronary and aortic calcification for 168 women, as measured by EBCT, in the Healthy Women Study (HWS) at the eighth postmenopausal visit. 1,2 In previous reports from the HWS, we evaluated the determinants of changes in cardiovascular risk factors from the premenopause, perimenopause, and postmenopause. 3 There was an increase in LDL cholesterol (LDL-C), little change in total HDL-C, a substantial decline in HDL 2 -C, and an increase in HDL 3 -C. The women gained Ϸ1 pound per year from the perimenopause through the postmenopausal years. Weight gain was associated with a substantial increase in LDL-C, triglycerides, and systolic blood pressure and a decrease in HDL-C levels. 4 In this article, we evaluated 2 hypotheses. First, we predicted that the cardiovascular risk factors that predict clinical cardiovascular disease in elderly women would also predict coronary and aortic calcification in middle-aged women. The extensive risk factor assessment was completed when the women...

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“…The general belief is that oophorectomy abolishes sexual dimorphism and causes women to develop a male pattern of blood pressure 17 and risk, 18,19 an effect which appears to be prevented by oestrogen-replacement therapy. 20 On the other hand, some authors believe that surgical menopause exerts an effect only on cholesterol 21 or LDL fraction, 22 or no effect at all on lipids, 23 and the role of sudden ovarian failure is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Blood pressure and metabolic profile after surgical menopause: comparison with fertile and naturally-menopausal women

et al. 2000

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In 1978 a random sample (367 men and 568 women aged 18-65 years) taken from the general population of a north-eastern Italian town was screened for cardiovascular risk; 16 years later, the women were invited to a second screening. Three groups were identified at the initial screening (fertile, naturally menopausal and surgically menopausal) and four in the longitudinal study (137 remained fertile during the whole study, 205 became naturally menopausal, 56 were ovariectomised and 127 were already going through the menopause). The protocol included a questionnaire, blood pressure (BP) measurement, and blood exams. Continuous variables were adjusted for confounders. Systolic BP, prevalence of hypertension, cholesterol, glycaemia and uricaemia were similar, whereas diastolic and triglycerides (TG) were lower in surgically-menopausal than in fertile women (P Ͻ 0.001). No significant difference in 16 years' variation from baseline was observed between

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Increased risk of atherosclerosis in women after the menopause

Abstract: The effects of a calciurn antagonist, nimodipine, upon physiological responses of the cerebral sasculature and its possible influence upon focal cerebral ischemia.

Cited by 56 publications

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Menopause and the characteristics of the large arteries in a population study

Menopause and the characteristics of the large arteries in a population study

Coronary and Aortic Calcification Among Women 8 Years After Menopause and Their Premenopausal Risk Factors

Blood pressure and metabolic profile after surgical menopause: comparison with fertile and naturally-menopausal women

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