Greater rise in CVD risk factors seen for women during menopause vs. same-age men

Levels of cholesterol, triglycerides and other serum components that indicate CVD risk increased for women in Japan who underwent menopause in the past 15 years, according to longitudinal data published in Menopause.

“Cross-sectional studies have shown that cardiovascular risk factors such as blood pressure, serum total cholesterol, [and] high-density lipoprotein cholesterol ... before menopause age differed from those after menopause age, and concordantly, cohort studies have reported that women who experienced early menopause, a short reproductive period or bilateral ovariectomy had higher overall mortality and increased risk and mortality from cardiovascular disease,” Saki Teramura, MSc, of the department of public health medicine at the University of Tsukuba in Japan, and colleagues wrote. “However, not many longitudinal studies have been conducted focusing on changes in cardiovascular risk factors after menopause age as compared with those before menopause age.”

Teramura and colleagues retrospectively collected data from participants in the ongoing Circulatory Risk in Communities Study in Japan. They identified 263 women who went through the menopause transition between 2007 and 2012 and who attended a health examination between 2001 and 2009 and between 2010 and 2018. They matched women to men by age, community and year of examination.

The researchers conducted in-person interviews with participants to obtain menstrual information, medical history and measurements of CV risk factors.

At enrollment, the mean age was 47.6 years for women and 47.7 years for men; at follow-up, the mean age was 58.4 years for both men and women. For women, the mean age at menopause was 51.4 years.

Between examinations, women had a greater increase in total serum cholesterol (16.7 vs. 3.1 mg/dL; P < .001), non-HDL cholesterol (15.9 vs. 6.3 mg/dL; P < .001), fasting triglycerides (1.2 vs. 1 mg/dL; P = .027), non-fasting triglycerides (1.2 vs. 0.9 mg/dL; P < .001), uric acid (0.5 vs. 0.2 mg/dL; P = .008), hemoglobin (0.9 vs. 0.3 g/dL; P < .001), aspartate aminotransferase (2.9 vs. 2.7 IU/L; P < .001) and alanine aminotransferase (2.9 vs. 2.6 IU/L; P < .001) compared with matched men.

There were no significant differences between men and women for changes in BMI, BP or HbA1c.

“Menopause may be a crucial factor related to changes in serum total cholesterol, non-high-density lipoprotein cholesterol, triglycerides, uric acid, hemoglobin and liver enzymes,” Teramura and colleagues wrote. “Enhanced lifestyle modifications and clinical management for cardiovascular risk factors among postmenopausal women may be helpful for preventing cardiovascular disease.”