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C-reactive protein is associated with aortic stiffness in a cohort of African American and white women transitioning through menopause

Woodard, Genevieve A. MD, PhD1; Mehta, Vinay G. PhD, MS2; Mackey, Rachel H. PhD1; Tepper, Ping PhD1; Kelsey, Sheryl F. PhD1; Newman, Anne B. MD, MPH1; Sutton-Tyrrell, Kim DrPH1

Menopause:
doi: 10.1097/gme.0b013e31821f81c2
Original Studies
Abstract

Objective: Arterial stiffness is a marker of cardiovascular health. Arterial stiffness and C-reactive protein (CRP) are linked to cardiovascular outcomes. Increases in both inflammation and arterial stiffness are known to occur with menopause. The association between CRP and arterial stiffness is well accepted; however, no study has determined whether there are differences in this association by menopause status and race, independent of age.

Methods: The cross-sectional association between CRP and aortic pulse wave velocity (PWV), a validated measure of central arterial stiffening, was evaluated in 307 African American and white women enrolled in an ancillary study to the Study of Women’s Health Across the Nation. Women were categorized into premenopausal or early perimenopausal (n = 185) and late perimenopausal or postmenopausal (n = 122).

Results: Natural log-transformed CRP was not associated with PWV in a linear regression model adjusted for age and cardiovascular risk factors (β = 15.9, P = 0.11). Moreover, models stratified by menopause status showed a linear relationship between CRP and PWV among late perimenopausal or postmenopausal women (β = 36.2, P = 0.049) but not for premenopausal or early perimenopausal women (β = 5.9, P = 0.61). The menopause status × log-transformed CRP and menopause status × race interactions were significant in their respective models adjusted for age and risk factors (P = 0.03 for both); however, when combined into one model, the two interactions were slightly attenuated (P = 0.063 and 0.052, respectively).

Conclusions: Menopause is strengthening the association between CRP and PWV, independent of age, and this effect seems to be stronger among African American women. This study provides a potential mechanism for the increased risk of cardiovascular disease among postmenopausal women.

Author Information

From the 1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh; and 2Department of Epidemiology, Merck and Co. Inc., Lansdale, PA.

Received March 5, 2011; revised and accepted April 13, 2011.

Funding/support: The Study of Women’s Health Across the Nation has grant support from the National Institutes of Health (NIH) and 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 (Grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495). The Study of Women’s Health Across the Nation Heart was supported by grants from the NIH through the National Heart, Lung, and Blood Institute (HL065581, HL065591).

Financial disclosure/conflicts of interest: None reported.

The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging, the National Institute of Nursing Research, the Office of Research on Women’s Health, or the NIH.

Address correspondence to: Genevieve A. Woodard, MD, PhD, 6303 Morrowfield Ave., Pittsburgh, PA 15217. E-mail: woodardg@edc.pitt.edu

©2011The North American Menopause Society