Predictors of subclinical atherosclerosis in postmenopausal women
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15 slide(s) – English – 2012-03-28
Predictors of subclinical atherosclerosis in postmenopausal women
E. Armeni1, K. Stamatelopoulos2, G. Georgiopoulos2, M. Kazani2, E. Kouskouni3, M. Creatsa1, A. Alexandrou1, C. Papamichael2, I. Lambrinoudaki1
12nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 2Department of Therapeutics, Univeristy of Athens, Alexandra Hospital, 3Biochemical Laboratory, University of Athens, Aretaieio Hospital, Athínai, Greece
Introduction: Women express atypical cardiovascular symptoms compared with men, leading to delayed diagnosis and higher case fatality rate. Furthermore, the cardiovascular risk is conferred by menopause.
Objective: To evaluate the risk factors determining the presence and extent of subclinical atherosclerosis in young postmenopausal women.
Methods: This cross-sectional study recruited 120 young, healthy, asymptomatic postmenopausal women, without clinically overt cardiovascular disease or diabetes. We evaluated biochemical and anthropometric parameters including the body mass index and waist-to-hip ratio. Indices of vascular function and structure included carotid-femoral pulse wave velocity, carotid and femoral intima-media thickness as well as atheromatous plaques presence both in carotid and femoral arteries. Subclinical atherosclerosis was defined as values of one or more of these indices in the abnormal range.
Results: Subjects with subclinical atherosclerosis were significantly older (54.0±3.8 vs. 52.2±4.3 years, p-value=0.020), had more years since menopause (p-value=0.0001), higher systolic blood pressure (p-value=0.001) and diastolic blood pressure (p-value=0.012), insulin levels (7.9±3.9 vs. 6.0±3.3, p-value=0.013) as well as HOMA-IR (p-value=0.025), compared with subjects without subclinical atherosclerosis. Years since menopause (relative risk = 4% for each increase of 1 mmHg, p-value=0.007) and systolic blood pressure (relative risk = 26.6% for each increase of years in menopause, p-value=0.021) independently determined subclinical atherosclerosis in the multivariate analysis.
Conclusions: The risk factors, mainly associated with the presence of subclinical atherosclerosis in postmenopausal women, are the number of years since menopause and systolic blood pressure, which had a more pronounced effect than any of the assessed metabolic indicators.
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