Premenopausal Factors Best Predict Postmenopausal Heart, Stroke Risk.

2001 MAY 24 - (NewsRx Network) -- A woman's cardiovascular risk factors such as cholesterol and blood pressure readings before menopause are a more accurate predictor of whether she will develop heart disease or stroke after menopause, researchers report in the May 2001 issue of Stroke, a journal of the American Heart Association.

"The premenopausal risk factors may be a stronger predictor of carotid atherosclerosis because they represent cumulative risk factor exposure during the premenopausal years whereas the risk factor changes during the early postmenopausal years have a shorter time for influence," says Karen A. Matthews, PhD, professor of psychiatry and epidemiology at the University of Pittsburgh Medical Center and lead author of the study.

This means that women who are at high risk for strokes and heart attacks after menopause can be identified during the years before menopause. "Prevention strategies should not be put off until menopause when a women's risk of cardiovascular disease increases dramatically," says Matthews.

The study was designed to describe changes in cardiovascular risk factors shortly before menopause and up to five years after menopause. A second goal was to evaluate the association between risk factors before and after menopause and carotid atherosclerosis.

The researchers evaluated 372 women (339 of whom were white) who completed examinations before menopause and again at one and five years after cessation of their menstrual cycles. Their average age was 47.5 at premenopause examinations in 1983 and 1984. The exams included measurements of cholesterol, blood pressure, glucose, body weight, and body mass index (BMI, which is weight in proportion to height).

Beginning in 1993, the postmenopausal exam included evaluation of the carotid arteries to determine whether thickening had occurred by ultrasound imaging; 314 of the 372 women had ultrasound studies.

During the time from perimenopausal (the few years immediately preceding menopause) to first-year postmenopausal examination, the changes in low-density lipoprotein (LDL), triglycerides, and BMI were larger than those between the first and fifth year after menopause. LDL increased .47 mmol/L (17.7 mg/dl) in perimenopause compared to an .06 mmol/L (2.5 mg/dl) increase after menopause; the triglyceride change was .23 mmol/L (20.5 mg/dl) and .11 mmol/L (9.3 mg/dl), respectively. Premenopausal risk factors were a stronger predictor of the