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Healthy lifestyle reduces risk for atherosclerosis during menopause
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Women who maintained a healthy lifestyle during the menopausal transition had less subclinical atherosclerosis, according to a study published in the Journal of the American Heart Association.
Ana Baylin, MD, DrPH, associate professor of nutritional sciences, epidemiology and global health at University of Michigan School of Public Health in Ann Arbor, and colleagues analyzed data from 1,143 women (mean age at baseline, 46 years) from the SWAN study who were not pregnant or lactating, had an intact uterus and at least one ovary, had at least one menstrual cycle in the past 3 months and were not using oral contraceptives or hormone therapy in the past 3 months. Women who reported having a stroke or heart disease at baseline or who developed either condition during follow-up were excluded.
Clinical assessments started in 1996, and women were followed up annually for approximately 15 years. Carotid ultrasound scans were performed during visit 12 or 13.
Researchers calculated a modified version of a Healthy Lifestyle Score, which took into consideration physical activity, smoking and diet quality. The Block food frequency questionnaire was used to collect dietary data at baseline, visit 5 and visit 9.
The outcomes of interest were the adventitial diameter of the common carotid artery, the intima-media thickness of the common carotid artery and the extent of carotid plaque.
During 10 years of follow-up, the average Healthy Lifestyle Score was associated with the adventitial diameter of the common carotid artery (P < .001) and intima-media thickness of the common carotid artery (P = .0031), which remained inversely associated after adjusting for physiological risk factors and risk factors.
Compared with women with the lowest level of the Healthy Lifestyle Score, those with the highest level had a smaller intima-media thickness (0.024 mm; 95% CI of beta coefficient, –0.048 to 0), which was associated with a 17% difference of the standard deviation. This was also seen for the adventitial diameter (0.16 mm; 95% CI of beta coefficient, –0.27 to –0.04), which equaled a difference of 24% of the standard deviation.
Smoking abstinence was strongly and inversely associated with the three measures of subclinical carotid atherosclerosis (P for trend for all < .01). Compared with women who smoked at some time during follow-up, those who never smoked had a 0.24 smaller adventitial diameter (95% CI of beta coefficient, –0.35 to –0.13; 36% difference in standard deviation), a 0.047 mm smaller intima-media thickness (95% CI of beta coefficient, –0.07 to –0.024; 34% difference in standard deviation) and were less likely to have an increased carotid plaque index (OR = 0.51; 95% CI, 0.35-0.73).
“This work highlights the growing recognition of the midlife as a critical window for CVD prevention and strongly supports the need for lifestyle interventions aimed at promoting these modifiable health behaviors in midlife women,” Baylin and colleagues wrote. – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
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