The perimenopausal atherosclerosis transition: relationships between calcified and noncalcified coronary, aortic, and carotid atherosclerosis and risk factors and hormone levels.
The perimenopausal atherosclerosis transition: relationships between calcified and noncalcified coronary, aortic, and carotid atherosclerosis and risk factors and hormone levels.
- 2012
Available online from MWHC library: November 2000 - present
CONCLUSIONS: Coronary, aortic, and carotid arterial plaque is prevalent in perimenopausal women without cardiac symptoms. The assessment of perimenopausal hormone status was not independently associated with subclinical atherosclerosis beyond standard cardiovascular risk factors. METHODS: The Assessment of the Transition of Hormonal Evaluation with Noninvasive Imaging of Atherosclerosis was a prospective substudy of the Prospective Army Coronary Calcium project. We screened 126 asymptomatic perimenopausal women (mean age, 50 y) using contrast-enhanced CT angiography (multidetector CT) and carotid ultrasound. Women had coronary calcium data from 5 to 10 years earlier. The measures included cardiovascular risk factors, serum hormone levels, 64-slice multidetector CT, and carotid ultrasound. OBJECTIVE: Women of perimenopause age experience an upward transition of cardiovascular risk possibly in association with changing hormonal status. We examined the cross-sectional relationships between the atherosclerotic plaque within the coronary and carotid arteries and aorta and the menopausal hormone levels among asymptomatic perimenopausal women. RESULTS: The prevalence of any coronary plaque was 35.5%. The prevalence of noncalcified plaque was 30.2%, and noncalcified plaque was the only manifestation of coronary artery disease in 10.7%. Markers of androgenicity (increased free testosterone and reduced sex hormone-binding globulin) were associated with an increased extent of calcified and noncalcified coronary artery plaque and aortic plaque. However, these relationships were not independent of cardiovascular risk factors. Follicle-stimulating hormone was directly associated with the number of aortic plaques. The levels of estrogen hormones were unrelated to plaque presence or extent.
English
1072-3714
*Aorta/pa [Pathology]
*Carotid Arteries/pa [Pathology]
*Coronary Vessels/pa [Pathology]
*Hormones/bl [Blood]
*Perimenopause/ph [Physiology]
*Vascular Calcification/pa [Pathology]
Atherosclerosis/ep [Epidemiology]
Atherosclerosis/pa [Pathology]
Cardiovascular Diseases/ep [Epidemiology]
Cardiovascular Diseases/pa [Pathology]
Cross-Sectional Studies
Female
Follicle Stimulating Hormone/bl [Blood]
Humans
Middle Aged
Plaque, Atherosclerotic/pa [Pathology]
Risk Factors
Sex Hormone-Binding Globulin/an [Analysis]
Testosterone/bl [Blood]
Tomography, X-Ray Computed
Ultrasonography
MedStar Heart & Vascular Institute
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Available online from MWHC library: November 2000 - present
CONCLUSIONS: Coronary, aortic, and carotid arterial plaque is prevalent in perimenopausal women without cardiac symptoms. The assessment of perimenopausal hormone status was not independently associated with subclinical atherosclerosis beyond standard cardiovascular risk factors. METHODS: The Assessment of the Transition of Hormonal Evaluation with Noninvasive Imaging of Atherosclerosis was a prospective substudy of the Prospective Army Coronary Calcium project. We screened 126 asymptomatic perimenopausal women (mean age, 50 y) using contrast-enhanced CT angiography (multidetector CT) and carotid ultrasound. Women had coronary calcium data from 5 to 10 years earlier. The measures included cardiovascular risk factors, serum hormone levels, 64-slice multidetector CT, and carotid ultrasound. OBJECTIVE: Women of perimenopause age experience an upward transition of cardiovascular risk possibly in association with changing hormonal status. We examined the cross-sectional relationships between the atherosclerotic plaque within the coronary and carotid arteries and aorta and the menopausal hormone levels among asymptomatic perimenopausal women. RESULTS: The prevalence of any coronary plaque was 35.5%. The prevalence of noncalcified plaque was 30.2%, and noncalcified plaque was the only manifestation of coronary artery disease in 10.7%. Markers of androgenicity (increased free testosterone and reduced sex hormone-binding globulin) were associated with an increased extent of calcified and noncalcified coronary artery plaque and aortic plaque. However, these relationships were not independent of cardiovascular risk factors. Follicle-stimulating hormone was directly associated with the number of aortic plaques. The levels of estrogen hormones were unrelated to plaque presence or extent.
English
1072-3714
*Aorta/pa [Pathology]
*Carotid Arteries/pa [Pathology]
*Coronary Vessels/pa [Pathology]
*Hormones/bl [Blood]
*Perimenopause/ph [Physiology]
*Vascular Calcification/pa [Pathology]
Atherosclerosis/ep [Epidemiology]
Atherosclerosis/pa [Pathology]
Cardiovascular Diseases/ep [Epidemiology]
Cardiovascular Diseases/pa [Pathology]
Cross-Sectional Studies
Female
Follicle Stimulating Hormone/bl [Blood]
Humans
Middle Aged
Plaque, Atherosclerotic/pa [Pathology]
Risk Factors
Sex Hormone-Binding Globulin/an [Analysis]
Testosterone/bl [Blood]
Tomography, X-Ray Computed
Ultrasonography
MedStar Heart & Vascular Institute
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.