Abstract P298: Progression Of Subclinical Atherosclerosis And Its Determinants In Early Postmenopausal Chinese Women - A Five-year Followup Study Of A Population-based Cohort

Abstract

Introduction: Subclinical atherosclerosis (SA) progresses silently over a period of time before the clinical manifestations of cardiovascular disease. Hypothesis: We hypothesize that early postmenopausal women with adverse cardiovascular risk factors or their progression to abnormal values have a higher risk of SA. This study aimed to investigate the progression of SA and its determinants in early postmenopausal Chinese women. Methods: This is a community-based 5-year followup study on a cohort of 518 women aged 50–64, within 10 years menopause, and recruited through random telephone dialing. Clinical assessments, fasting blood samples, lifestyle and dietary variables based on validated and structured questionnaires, as well as intima-media thickness (IMT) were obtained at baseline and at followup. IMT was measured using a 12.5-MHz linear probe of the HDI 5000 ultrasound scanner at the near and far walls of three 10-mm segments: distal common carotid, bifurcation, proximal internal carotid of both the left and right carotid arteries. Plaque was defined as a focal wall thickening of at least 1.5mm and graded as: grade 0, 1 and 2. Plaque progression was the difference of the plaque index at baseline and followup, and classified into 3 categories. Results: This study of Chinese early postmenopausal women (followup mean age 61.5 years at followup) has revealed a progression of IMT of 2.1% per year (standard deviation = 1.7). 17% were found to have a moderate and 8% severe plaque progression. Stepwise multiple regression analyses showed that baseline IMT, age, low density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure were significant predictors of higher followup IMT, while vegetable and fruit intake were inversely related. Women with values belonging to the “normal” ranges of blood pressure, waist circumference, lipid and fasting blood glucose levels had lower IMT at followup compared to those with abnormal baseline values and those with progression from “normal” to the “abnormal” ranges. Women with high soy-vegetable-fruit intake at both baseline and followup had lower IMT than those with low intakes at both time points. Increasing age, waist circumference ≥80 cm, cholesterol ≥200 mg/L, having diabetes, regular drinking were significant predictors of plaque progression (adjusted odds ratios from 1.10 to 2.81), while higher vegetable and fruit intake lowered the risk. Conclusion: Age, central obesity, diabetes, dislipidaemia, high blood pressure, regular drinking were significant predictors for an increased risk of SA. Maintenance of these CVD factors within normal ranges through early menopausal years with adequate fruit and vegetable intake is important to reduce the progression of SA.