Lipid changes around the final menstrual period predict carotid subclinical disease in postmenopausal women

Karen A. Matthews, Samar R. El Khoudary, Maria M. Brooks, Carol A. Derby, Siobán D. Harlow, Emma J M Barinas-Mitchell, Rebecca C. Thurston

Research output: Contribution to journalArticle

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Abstract

Background and Purpose - Atherogenic changes in lipids occur among women around the time of the natural menopause, that is, within 1 year of the final menstrual period (FMP). We investigated whether lipid changes around the FMP are related to carotid intima-media thickness, interadventitial diameter, and plaque in postmenopausal women. Methods - A total of 863 natural postmenopausal women with no history of heart attack or stroke underwent carotid ultrasound scans at follow-up year 12 or 13 of the Study of Women's Health Across the Nation. Estimates of their annual change in lipids were segmented into the year before and after the FMP, before the year before FMP, and 1 year after FMP. Multivariate analyses were adjusted for sociodemographic characteristics, time from FMP to scan, baseline body mass index and systolic blood pressure, and use of medications for hypertension and diabetes mellitus at the scan. Results - Smaller increases in high-density lipoprotein cholesterol and apolipoprotein A1 within 1 year of the FMP were related to greater interadventitial diameter, β (SE)=-0.036 (0.015), P=0.02, and β (SE)=-0.035 (0.013), P=0.006, respectively. Greater increases in low-density lipoprotein cholesterol within 1 year of FMP were related to greater likelihood of plaque scores ≥2, odds ratio, 1.071; 95% confidence interval, 1.018-1.127; P=0.009. Magnitude of associations was reduced but remained significant with further adjustment for premenopausal lipid levels. The difference in probability of elevated plaque scores was 50% between those in the highest and lowest low-density lipoprotein cholesterol change tertiles. Conclusions - Changes in lipids as women approach the FMP provide useful clinical information for understanding postmenopausal carotid indices.

Original languageEnglish (US)
Pages (from-to)70-76
Number of pages7
JournalStroke
Volume48
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Lipids
LDL Cholesterol
Blood Pressure
Carotid Intima-Media Thickness
Apolipoprotein A-I
Women's Health
Menopause
HDL Cholesterol
Diabetes Mellitus
Body Mass Index
Multivariate Analysis
Stroke
Odds Ratio
Myocardial Infarction
Confidence Intervals
Hypertension

Keywords

  • atherosclerosis
  • body mass index
  • cholesterol
  • lipids
  • menopause
  • race

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Matthews, K. A., El Khoudary, S. R., Brooks, M. M., Derby, C. A., Harlow, S. D., Barinas-Mitchell, E. J. M., & Thurston, R. C. (2017). Lipid changes around the final menstrual period predict carotid subclinical disease in postmenopausal women. Stroke, 48(1), 70-76. https://doi.org/10.1161/STROKEAHA.116.014743

Lipid changes around the final menstrual period predict carotid subclinical disease in postmenopausal women. / Matthews, Karen A.; El Khoudary, Samar R.; Brooks, Maria M.; Derby, Carol A.; Harlow, Siobán D.; Barinas-Mitchell, Emma J M; Thurston, Rebecca C.

In: Stroke, Vol. 48, No. 1, 01.01.2017, p. 70-76.

Research output: Contribution to journalArticle

Matthews, KA, El Khoudary, SR, Brooks, MM, Derby, CA, Harlow, SD, Barinas-Mitchell, EJM & Thurston, RC 2017, 'Lipid changes around the final menstrual period predict carotid subclinical disease in postmenopausal women', Stroke, vol. 48, no. 1, pp. 70-76. https://doi.org/10.1161/STROKEAHA.116.014743
Matthews, Karen A. ; El Khoudary, Samar R. ; Brooks, Maria M. ; Derby, Carol A. ; Harlow, Siobán D. ; Barinas-Mitchell, Emma J M ; Thurston, Rebecca C. / Lipid changes around the final menstrual period predict carotid subclinical disease in postmenopausal women. In: Stroke. 2017 ; Vol. 48, No. 1. pp. 70-76.
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AU - Harlow, Siobán D.

AU - Barinas-Mitchell, Emma J M

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