Women’s CV risk increases with age, not reproductive stage
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Menopausal women tend to have worse cardiovascular risk profiles than premenopausal women, but 5-year increases in CV risk factors are not dependent on reproductive stage, according to data from the CoLaus study.
Pedro Marques-Vidal, MD, PhD, associate professor in the department of nuclear medicine at Lausanne University Hospital, University of Lausanne, Switzerland, and colleagues conducted the prospective, population‐based cohort CoLaus study to better understand whether changes in women’s CVD risk factors differ by reproductive stage independently of underlying aging trajectories.
Study participants included women who did not use hormone therapy and were followed from 2003 to 2012 for a mean of 5.6 years. Researchers classified women into four categories based on baseline and follow-up comparisons of their menstruation status: premenopausal, menopausal transition, early postmenopausal ( 5 years) and late postmenopausal (> 5 years).
Researchers used repeated measures of fasting lipids, glucose and CV inflammatory markers for longitudinal analysis, with premenopausal women serving as a reference category, and adjusted analyses for age, medication use and lifestyle factors.
The study featured data from 1,710 women who were aged 35 to 75 years.
The analysis revealed that changes in CVD risk factors did not differ in the other three menopausal categories compared with premenopausal women.
When researchers used age as a predictor variable and adjusted for menopause status, they found that most CVD risk factors rose, whereas interleukin‐6 and interleukin‐1 beta decreased with advancing age.
“All women increase their cardiovascular risk as they get older, and in our study, we found no differences in cardiovascular risk changes comparing women in advanced reproductive stages with premenopausal women,” researchers wrote. “This highlights the strong association between chronological age and the cumulative deleterious effects in CVD risk for women. More longitudinal studies that use novel biomarkers for ovarian age are still needed to disentangle the association between menopause and CVD risk in postmenopausal women and women in the menopause transition. ... It would be prudent to do screening and preventive measures during menopause transition as these are also ageing women with inherent cardiovascular risks. Cardiovascular preventive measures should target not only postmenopausal women, but also women in the transition phase while waiting for more conclusive evidence.”