Abstract 17840: Progression of Cardiovascular Risk Factors Across the Menopausal Transition - Results from Study of Women’s Health Across the Nation

Abstract

Objectives: To correlate arterial compliance and measures of subclinical atherosclerosis with menopausal status during menopausal transition. Background: Cardiovascular risk increases in women after the menopausal transition. To assess factors that might explain this increased risk, we used radial tonometry to measure arterial compliance in SWAN (Study of Women’s Health Across the Nation), a longitudinal study of women in the menopausal transition. Methods: Raw waveforms were digitized and a generalized transfer function was utilized to calculate central Augmentation Pressure (cAP) & aortic Augmentation index (AIx) adjusted for heart rate of 75bpm. Carotid intima-media thickness (cIMT) was calculated using B-mode ultrasound. Coronary artery calcium (CAC) and thoracic aortic calcium (TAC) scores were obtained by computed tomography. Pulse wave velocity (PWV) was recorded as time taken for the arterial pulse to propagate from the carotid to the femoral artery. Results: Mean age was 52±9, BMI 28±6; 7% of women were premenopausal, 48% perimenopausal, and 45% were postmenopausal. PWV, cAP, cIMT, CAC and TAC were higher in post-menopause than peri-menopause and lowest in the premenopausal group with a similar trend for AIx (see Table). Higher PWV correlated significantly with higher cIMT (r=0.32), cAP (r=0.34), AIx (0.17), CAC (r=0.13) & TAC (r=0.19). Conclusion: Physiologic measures of arterial stiffness were higher through the menopausal transition along with morphologic measures of subclinical atherosclerosis, with a correlation between the two. Such changes may help to explain the increased risk of cardiovascular disease in women after menopause and may be assessed using a combination of physiologic and morphologic parameters. Supported by NIH/DHHS (grants U01AG012505, U01AG012546, R01HL065581, R01HL065591, R01HL089862).