11/14/2012
Carotid artery change in menopause may mean more cardiovascular disease risk
Substantial changes in the diameter and thickness of a section of carotid artery in perimenopausal women may indicate a higher risk of developing cardiovascular disease, the leading cause of death in women, according to Pitt researchers.

Epidemiologists studied 249 women aged 42-52 from the Pittsburgh site of the Study of Women’s Health Across the Nation (SWAN) observational study. Each participant was given up to five ultrasound scans during transitional phases of menopause to measure the thickness and diameter of a section of the carotid artery. Researchers noted significant increases in the average thickness (0.017 mm per year) and diameter (0.024 mm per year) of the carotid artery during the late perimenopausal stage, the period of time when menstruation ceases for more than three consecutive months.

These increases were significantly higher than those found in the premenopausal stage.

Samar R. El Khoudary, lead author of the study and a public health faculty member, said: “These data highlight late perimenopause as a stage of vascular remodeling during which arteries become more vulnerable, regardless of a woman’s age and ethnicity.”

The study is available online and will be printed in the January 2013 issue of Menopause: The Journal of the North American Menopause Society.

The findings also suggest that the changes in the diameter of the arterial wall may occur first in response to lower levels of estrogen during perimenopause.

The thickening of the arterial wall likely follows as the body adjusts to the increased stress from the dilated artery, said El Khoudary. Late perimenopause also is the time during which women gain weight and face changes in lipid profiles and body fat distribution.

Those risk factors in combination with the vascular changes may place older women at risk for developing atherosclerosis, said El Khoudary.

“Our current study highlights late perimenopause as a time when early intervention strategies targeting cardiovascular disease might yield the greatest benefit,” she added.

Pitt contributing authors included Joyce T. Bromberger and Kim Sutton-Tyrrell, both of public health, and Karen Matthews and Rebecca C. Thurston, both of the School of Medicine.

SWAN received support from NIH, the Department of Health and Human Services through the National Institute on Aging, the National Institute of Nursing Research and the NIH Office of Research on Women’s Health.

The Study of Women’s Health Across the Nation Heart was supported by the National Heart, Lung and Blood Institute.