- For women in the menopausal transition, 3 factors are key to reduced subclinical atherosclerotic cardiovascular disease (ASCVD) risk: healthy diet, regular physical activity, and not smoking.
- Not smoking shows the strongest association with risk reduction.
Why this matters
- These findings emphasize that the menopausal transition is an important stage in ASCVD risk and a “critical window” for prevention.
- Healthy lifestyle scores stayed stable; physical activity levels changed somewhat, but smoking status and diet did not.
- Only 1.7% maintained high scores for all 3 factors.
- Average high scores for 10 years of follow-up were inversely associated with 3 markers of subclinical ASCVD:
- Common carotid intima-media thickness: P=.0031;
- Adventitial diameter: P<.001>
- Carotid plaque: P=.024 (significance lost with further adjustment).
- Smoking was inversely associated with all 3 measures (P<.01>
- J-shaped association: highest healthy lifestyle score level had similar or higher risk measures vs second highest level.
- 1143 women in the Study of Women's Health Across the Nation ( SWAN ).
- 3 markers measured: common carotid artery intima-media thickness, adventitial diameter, and carotid plaque.
- 3 factors assessed by self-report: smoking, diet, physical activity.
- Funding: NIH.
- Only 1 measure of markers; no baseline subclinical ASCVD status.
- Self-report data.