Author + information
- Received April 17, 2009
- Revision received October 13, 2009
- Accepted October 17, 2009
- Published online December 15, 2009.
- Karen A. Matthews, PhD*,†,* (, )
- Sybil L. Crawford, PhD‡,
- Claudia U. Chae, MD§,
- Susan A. Everson-Rose, PhD∥,
- Mary Fran Sowers, PhD¶,
- Barbara Sternfeld, PhD# and
- Kim Sutton-Tyrrell, PhD†
- ↵*Reprint requests and correspondence:
Dr. Karen A. Matthews, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213
Objectives This prospective study examined whether changes in traditional and novel coronary heart disease (CHD) risk factors are greater within a year of the final menstrual period (FMP), relative to changes that occur before or after that interval, in a multiethnic cohort.
Background Understanding the influence of menopause on CHD risk remains elusive and has been evaluated primarily in Caucasian samples.
Methods SWAN (Study of Women's Health Across the Nation) is a prospective study of the menopausal transition in 3,302 minority (African American, Hispanic, Japanese, or Chinese) and Caucasian women. After 10 annual examinations, 1,054 women had achieved an FMP not due to surgery and without hormone therapy use before FMP. Measured CHD risk factors included lipids and lipoproteins, glucose, insulin, blood pressure, fibrinogen, and C-reactive protein. We assessed which of 2 models provided a better fit with the observed risk factor changes over time in relation to the FMP: a linear model, consistent with chronological aging, or a piecewise linear model, consistent with ovarian aging.
Results Only total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B demonstrated substantial increases within the 1-year interval before and after the FMP, consistent with menopause-induced changes. This pattern was similar across ethnic groups. The other risk factors were consistent with a linear model, indicative of chronological aging.
Conclusions Women experience a unique increase in lipids at the time of the FMP. Monitoring lipids in perimenopausal women should enhance primary prevention of CHD.
SWAN (Study of Women's Health Across the Nation) has grant support from the National Institutes of Health (NIH), Department of Health and Human Services, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR), and the NIH Office of Research on Women's Health (ORWH)(grants NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, and AG012495). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH, or the NIH.
- Received April 17, 2009.
- Revision received October 13, 2009.
- Accepted October 17, 2009.
- American College of Cardiology Foundation