Premenopausal gender-related atheroprotective effect offset early in menopausal life
MedWire News: Recently postmenopausal women have the same prevalence of subclinical carotid atherosclerosis as age- and traditional risk factor-matched men, report researchers.
This was observed both for early and advanced stages of subclinical carotid atherosclerosis, they say.
The findings arise from a cross-sectional analysis of 85 men and 101 postmenopausal women in the first decade of menopause. All participants were aged 40-60 years and free from cardiovascular disease (CVD).
The researchers assessed subclinical carotid atherosclerosis by high-resolution ultrasonography in all individuals. The presence of subclinical atherosclerosis was defined as any segment with intima-media thickness (IMT) above 0.9 mm and/or plaque, while the extent of subclinical atherosclerosis was defined as the number of segments with IMT above 0.9 mm and with plaque.
Kimon Stamatelopoulos (University of Athens, Greece) and colleagues found that subclinical carotid arterial disease in this population was not determined by gender.
When they matched the population for age and traditional risk factors (body mass index, undiagnosed and/or untreated dyslipidemia and hypertension, and smoking), resulting in a subsample of 76 men and women, they found that the prevalence and extent of carotid atherosclerosis was similar between genders.
Specifically, there was no significant difference between carotid IMT (0.717 vs 0.734 mm) and the number of segments with atherosclerosis (1.47 for both genders) between men and women. The presence of increased IMT (60.5% for both genders), carotid plaques (28.9 vs 31.6%), and subclinical atherosclerosis (65.8 vs 63.2%) were also similar for both genders.
Writing in the journal Atherosclerosis, Stamatelopoulos et al say that practitioners tend to consider CVD to be a "male problem," mainly due to the premenopausal atheroprotective role of estrogens.
"Our results indicate that contrary to popular belief, subclinical atherosclerosis is prevalent in young menopausal women, to the same extent as in men matched for traditional risk factors."
They add: "These findings suggest that the 'non-traditional' residual risk in menopause may offset the premenopausal gender-related atheroprotective effects very early in menopausal life."
An approach to risk-stratify and treat young postmenopausal women, irrespective of gender, may be useful if these findings are confirmed in other studies, they conclude.
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By Nikki Withers