Association of menopause and hormone replacement therapy with large artery remodeling

Abstract

Objective: To evaluate the remodeling of large arteries according to age at menopause, duration of menopause, and use of hormone therapy (HT).

Design: A cross-sectional study consisting of baseline measurements of a multicentric randomized trial were used to evaluate arterial parameters.

Setting: The study was conducted in France, Belgium, and the Netherlands in academic hospitals and private clinics.

Patient(s): Postmenopausal women (n = 538) with mild hypercholesterolemia.

Intervention(s): None.

Main outcome measure(s): Common carotid artery intima-media thickness (CCA-IMT), central pulse pressure, and aortic stiffness (carotid-femoral pulse wave velocity) were measured and centrally controlled for quality. Multivariate regression analysis was used to assess the possible covariates associated with arterial parameters.

Result(s): Women were 58 ± 6 (mean ± SD) years of age with an age of 50 ± 5 at menopause and a mean duration of menopause of 8 ± 7 years. Lower age at menopause, time since menopause, and absence of HT use were independently associated with worsening of the arterial parameters. After multivariate analysis, HT was associated with a lower CCA-IMT (-40 μm [range -64 to -1]), whereas lower age at menopause and menopause duration were respectively associated with a CCA-IMT increase (25 μm/5 y and 27 μm/5 y). Similarly, values of central pulse pressure and pulse wave velocity were lower in HT users (-3.1 mm Hg [-5.1 to -0.9] and -0.31 m/s [-0.63 to -0.02], respectively) but worsened with age at menopause and menopause duration.

Conclusion(s): The age at menopause, the time since menopause, and the use of HT are independently associated with the thickening and stiffening of the large arteries.

Clinical trial registration number: NCT00163163.