Menopause transition is a critical window for cardiovascular health

  • J Am Heart Assoc

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • 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.

Key results

  • 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.

Study design

  • 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.

Limitations

  • Only 1 measure of markers; no baseline subclinical ASCVD status.
  • Self-report data.

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