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Progression rates of carotid intima-media thickness and adventitial diameter during the menopausal transition

El Khoudary, Samar R. PhD, MPH1; Wildman, Rachel P. PhD, MPH2; Matthews, Karen PhD3; Thurston, Rebecca C. PhD3; Bromberger, Joyce T. PhD1,3; Sutton-Tyrrell, Kim DrPH1

Menopause:
doi: 10.1097/gme.0b013e3182611787
Original Articles
Editorial
Abstract

Objective: The aim of this study is to assess whether the levels and progression rates of carotid intima-media thickness (IMT) and adventitial diameter (AD) vary by menopausal stage.

Methods: Two hundred forty-nine women (aged 42-57 y; 49% premenopausal and 46% early perimenopausal) from the Study of Women’s Health Across the Nation were included in the current analysis. Participants were followed up for up to 9 years (median, 3.7 y) and underwent up to five carotid scans. Linear mixed-effect models were used for the analysis.

Results: The overall rate of change in IMT was 0.007 mm/year. Independent of age and race, the progression rate of IMT increased substantially in the late perimenopausal stage (0.017 mm/y) compared with both the premenopausal stage (0.007 mm/y) and the early perimenopausal stage (0.005 mm/y; P ≤ 0.05). For AD, although the overall rate of change was negative (−0.009 mm/y), significant positive increases in the rate of change were observed in the late perimenopausal stage (0.024 mm/y) and the postmenopausal stage (0.018 mm/y) compared with the premenopausal stage (−0.032 mm/y; P < 0.05). In the final models, the postmenopausal stage was independently associated with higher levels of IMT and AD (P < 0.05) compared with the premenopausal stage.

Conclusions: During the menopausal transition, the carotid artery undergoes adaptation that is reflected in adverse changes in IMT and AD. These changes may have an impact on the vulnerability of the vessel to disease in older women.

Author Information

From the 1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; 2Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY; and 3Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Received April 9, 2012; revised and accepted May 21, 2012.

Funding/support: The Study of Women’s Health Across the Nation received grant support from the National Institutes of Health (NIH), Department of Health and Human Services, through the National Institute on Aging, National Institute of Nursing Research, and NIH Office of Research on Women’s Health (grants NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, and AG012495). The Study of Women’s Health Across the Nation Heart was supported by the National Heart, Lung, and Blood Institute (grants HL065581 and HL065591).

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

Financial disclosure/conflicts of interest: None reported.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.menopause.org).

Address correspondence to: Samar R. El Khoudary, PhD, MPH, Epidemiology Data Center, University of Pittsburgh, Room 5, First Floor, Keystone Building, 3520 Fifth Avenue, Pittsburgh, PA 15213. E-mail: elkhoudarys@edc.pitt.edu

© 2013 by The North American Menopause Society.