CV risk in women increases with age, not reproductive stage
Postmenopausal women tend to have worse cardiovascular risk profiles than premenopausal women, but 5-year increases in CV risk factors do not depend on reproductive stage, according to data from the CoLaus study.
Pedro Marques VidalMD, PhD, Associate Professor in the Department of Nuclear Medicine, University Hospital of Lausanne, University of Lausanne, Switzerland, and colleagues conducted the prospective population-based cohort study CoLaus to better understand whether changes in CVD risk factors in women differ by reproductive stage, independent of underlying aging trajectories.
Study participants included women who had not used hormone therapy and were followed from 2003 to 2012 for an average of 5.6 years. The researchers categorized the women into four categories based on baseline and follow-up comparisons of their menstrual status: premenopause, transitional menopause, early postmenopause (5 years), and late postmenopause (>5 years).
Pedro Marques Vidal
The researchers used repeated measurements of fasting lipids, glucose, and CV inflammatory markers for longitudinal analysis, with premenopausal women serving as the reference category, and analyzes adjusted for age, medication use and lifestyle factors.
The study presented data from 1,710 women between the ages of 35 and 75.
The analysis revealed that changes in CVD risk factors did not differ in the other three categories of menopause compared to premenopausal women.
When researchers used age as a predictor variable and adjusted for menopausal status, they found that most CVD risk factors increased, while interleukin-6 and interleukin-1 beta decreased with age.
“All women increase their cardiovascular risk as they age, and in our study, we found no difference in changes in cardiovascular risk when comparing late reproductive women with premenopausal women,” wrote the researchers. “This highlights the strong association between chronological age and cumulative deleterious effects on CVD risk in women. Further longitudinal studies using new biomarkers for ovarian age are still needed to unravel the association between menopause and CVD risk in postmenopausal women and women in menopausal transition. … It would be prudent to do screening and preventative measures during the menopausal transition as these are also aging women with inherent cardiovascular risks. Cardiovascular preventive measures should target not only postmenopausal women, but also transitional women pending more conclusive evidence.