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Oxidative stress contributes to large elastic arterial stiffening across the stages of the menopausal transition

Hildreth, Kerry L. MD; Kohrt, Wendy M. PhD; Moreau, Kerrie L. PhD

doi: 10.1097/GME.0000000000000116
Original Articles

Objective It is unclear how changes in ovarian hormones during the menopausal transition contribute to age-associated arterial stiffening. We sought to evaluate differences in arterial stiffness and the role of oxidative stress across the stages of the menopausal transition in healthy women.

Methods Arterial stiffness (carotid artery compliance and ultrasound) was measured during immediate infusions of saline (control) and ascorbic acid (experimental model to immediately decrease oxidative stress) in 97 healthy women (22-70 y) classified as premenopausal (n = 24; mean [SD] age, 33 [7] y), early perimenopausal (n = 21; 49 [3] y) or late perimenopausal (n = 21; 50 [4] y), or postmenopausal (n = 31; 57 [5] y).

Results Basal carotid artery compliance was different among the groups (P < 0.001). Mean [SD] compliance was highest in premenopausal women (1.31 [0.25] mm2/mm Hg × 10−1), with progressive decrements in perimenopausal (early perimenopausal, 0.98 [0.31] mm2/mm Hg × 10−1; late perimenopausal, 0.90 [0.25] mm2/mm Hg × 10−1) and postmenopausal (0.75 [0.24] mm2/mm Hg × 10−1) women. Ascorbic acid infusion improved compliance in late perimenopausal (15% [18%] increase, P = 0.001) and postmenopausal (17% [26%] increase, P = 0.002) women but not in early perimenopausal or premenopausal women.

Conclusions Arterial stiffening worsens across the stages of the menopausal transition in healthy women. This seems to be mediated, in part, by oxidative stress, particularly during the late perimenopausal and postmenopausal periods. It remains uncertain whether this is specifically caused by loss of ovarian function or aging.

Supplemental digital content is available in the text.

From the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO.

Received June 10, 2013; revised and accepted August 27, 2013.

Funding/support: This work was supported by the National Institutes of Health (awards R01 AG027678 and K01 AG20683), the Colorado Clinical and Translational Sciences Institute (grant UL1 TR000154), the Colorado Nutrition Obesity Research Center (grant P30 DK048520), and the University of Colorado Center for Women’s Health Research.

Financial disclosure/conflicts of interest: None reported.

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Address correspondence to: Kerrie L. Moreau, PhD, 12631 East 17th Avenue, Mail Stop B-179, Aurora, CO 80045. E-mail:

© 2014 by The North American Menopause Society.