Síndrome vasomotor: puente de unión entre la disfunción endotelial y la esclerosis arterial

Abstract

IntroductionVasomotor symptoms and endothelial dysfunction probably result in a post-menopausal oestrogen deficiency. However, the relationship of both with the progression of atherosclerosis is a controversial subject. ObjectiveTo identify the presence of sub-clinical atherosclerosis in middle-aged women with endothelial dysfunction, as well as cardiometabolic changes during the transition to the menopause. MethodA cross-sectional, observation study was conducted on 43 women between 40 and 59 years of age, with previous endothelial dysfunction, and 14 women with normal endothelial function. The variables recorded in each woman were, signs of arterial stiffening epicardial fat thickness and their relationship with anthropometric variables, intensity of the vasomotor symptoms, stages of menopause, and oestradiol levels. Statistical analysisMultiple linear regression and logistic regression was performed in order to identify an association between the intensity of the vasomotor symptoms, arterial stiffness, and cardiometabolic parameters. A P<.05 was significantly significant. ResultsThe arterial stiffness parameters (pulse wave propagation (PWP), Arterial distensibility, augmentation index), and that of atherosclerosis (carotid intima-media thickness, GIMc), and the thickness of the epicardial fat showed no changes compatible with arterial damage. At a higher intensity of vasomotor symptoms, a higher probability of an increase in PWP was found. Evolutionarily, a sub-group of women developed metabolic changes and endothelial dysfunction with no relationship with low oestrogens, age, or the stage of the menopause. ConclusionsA greater intensity of vasomotor symptoms could be a marker for the early identification of the risk for clinical atherosclerosis.