Abstract 5025: Transition to Menopause and Preclinical Atherosclerosis in Women: A Report from the Los Angeles Atherosclerosis Study (LAAS)

Abstract

While the relation between the onset of menopause and accelerated cardiovascular risk has been extensively studied, little information exists on the relationship of the menopausal transition and the development of preclinical atherosclerosis in women. We hypothesized that transition to menopause would be associated with a higher rate of progression of preclinical atherosclerosis. Methods: We evaluated 203 women (131 postmenopausal, 20 perimenopausal, and 52 premenopausal at entry) undergoing carotid intimal-media thickness (cIMT) measurement in the LAAS study, a prospective cohort study that included women aged 45– 60 years at entry without diagnosed cardiovascular disease who underwent three measurements (baseline, 1.5 and 3 year followup). cIMT was measured bilaterally in two body positions (lateral and supine), and average thickness over a 1 cm segment of the distal wall 25 mm proximal to the bulb was measured using automated edge-tracking software. Results: The mean age was 52±4 years, mean body mass index was 27.2±5.8, and 49% were non-white. At entry, 53% had hypertension, 3% diabetes, 16% were current smokers. Age-adjusted cIMT progression rate was similar among pre-, peri- and postmenopausal women (9±15 μ/yr) at entry, and similar among women who remained premenopausal (n=21) compared to those that transitioned to menopause (n=51) and to those who remained postmenopausal (n=131) during the observation period. Of the 51 transitioning women, age was not related to rate of cIMT progression. However, the rapidity of menopausal transition was related to the rate of IMT progression: women transitioning from pre to postmenopause within the 3 year period had a higher rate of cIMT progression compared to women with a slower transition (progressing from pre- to perimenopause, or from peri- to postmenopause, p=0.03). Additional adjustment of these results for systolic blood pressure and BMI did not alter the results. Conclusions: Among women undergoing repeated cIMT measurement in the LAAS, a more rapid menopausal transition (from pre- to postmenopause within 3 years) was associated with a higher rate of preclinical atherosclerosis progression; alternatively, menopausal status itself did not appear to be associated with rate of progression.