Abstract P137: Accelerated Arterial Stiffness During the Menopausal Transition - Results from Study of Women’s Health Across the Nation
Background: Arterial stiffness is an independent marker of cardiovascular disease (CVD). We hypothesized that arterial stiffness would increase in women undergoing menopausal (MP) transition.
Methods: 349 healthy, peri-MP participants from SWAN-Heart, an ancillary study of SWAN (Study of Women’s Health Across the Nation) were evaluated for subclinical atherosclerosis at baseline and again at 2 years. Subjects using hormone replacement (15) or vasodilators (38) were excluded. Radial tonometry waveforms were digitized and a transfer function was utilized to calculate Aortic Augmentation index, adjusted for heart rate of 75bpm (AIx@75). Pulse wave velocity (PWV) was recorded as carotid-to-femoral arterial pulse propagation time. Carotid intima-media thickness (cIMT) was measured by ultrasound. Women were grouped into pre/early-MP (PMP) and late peri/post-MP (LMP). Kruskal-Wallis test was utilized to compare differences among groups.
Results: Mean duration of follow up was 2.4 years with a retention rate of 69% (203/296). Age at baseline was (mean±SD) 51±3, BMI 29±6; 46 subjects transitioned from PMP to LMP, 82 remained at PMP and 75 at LMP. Peripheral blood pressure (BP) readings did not differ among groups at baseline or follow up (mean, 120/77 mmHg at both). Augmentation index ([[Unable to Display Character: ∆]]AIx@75) changed from 35±6 to 40±6%, for a difference of 5±8, for women transitioning from PMP to LMP vs 34±8 to 34±6% in women staying in PMP and 36±8 to 38±9% in women staying at LMP, p=.04. The trend for [[Unable to Display Character: ∆]]PWV was similar in PMP to LMP, changing from 6.9 to 8.4 m/s ([[Unable to Display Character: ∆]] = 1.5±2.1) compared to PMP, from 7.4 to 8.3 m/s ([[Unable to Display Character: ∆]] = 0.9±1.9) and LMP, from 8 to 8.4 m/s ([[Unable to Display Character: ∆]] = 0.4±2.5), p=.19. There was no difference in cIMT change between all groups; from 0.67 to 0.7 mm ([[Unable to Display Character: ∆]] = 0.03±0.05) in PMP to LMP, from 0.64 to 0.68 mm ([[Unable to Display Character: ∆]] = 0.04±0.05) in PMP and from 0.64 to 0.68 mm ([[Unable to Display Character: ∆]] = 0.04±0.07) in LMP.
Conclusion: Augmentation index, a physiologic measure of arterial stiffness, increased through the menopausal transition. There was no significant difference in cIMT change, showing that physiological changes occur before detectable morphologic changes in arterial vasculature in this setting. Changes in arterial stiffness occur first and may mediate the increased CVD risk in women undergoing menopause.
Author Disclosures: Z.A. Khan: None. I. Janssen: None. J.K. Mazzarelli: None. L.H. Powell: None. A. Dumasius: None. S.A. Everson-Rose: None. E. Barinas-Mitchell: None. P.J. Weinstock: None. S.M. Hollenberg: None.
- © 2015 by American Heart Association, Inc.