Samar R. El Khoudary, PhD, MPH, BPharm, FAHA Associate Professor, Epidemiology PITT Public Health Epidemiology Data Center University of Pittsburgh Pittsburgh, PA 15260 

Vascular Stiffness Increases in Year Before Menopause Interview with:

Samar R. El Khoudary, PhD, MPH, BPharm, FAHA Associate Professor, Epidemiology PITT Public Health Epidemiology Data Center University of Pittsburgh Pittsburgh, PA 15260 

Dr. El Khoudary

Samar R. El Khoudary, M.D., M.P.H.
Associate Professor of Epidemiology


Saad Samargandy, M.P.H.
Ph.D. Student
University of Pittsburgh Graduate School of Public Health What is the background for this study?

Response: Research findings suggest that women experience adverse changes in multiple clinical measures of their cardiovascular health during the menopause transition period. We were interested in evaluating the timing of critical changes in arterial stiffness and investigating potential racial differences in how arterial stiffness progresses during the menopause transition. Arterial stiffness refers to the elasticity of arteries and it measures the rate at which blood flows through arteries. Stiffer arteries can lead to dysfunction in how well the heart pumps and moves blood, and damage to the heart, kidneys and other organs.

We used a subset of data from SWAN Heart, an ancillary study that enrolled women from Pittsburgh and Chicago between 2001 and 2003 and included two examinations of early markers of cardiovascular health over time. Ultimately, 339 women were included in this study, 36% black and the rest white. What are the main findings? 

Response: On average, as women went through menopause, their arterial stiffness increased by about 0.9% up to one year before their last menstrual period to about 7.5% within one year before and after their last period, a considerable acceleration. The black women in the study experienced greater increases in arterial stiffness earlier in the transition than white women, more than a year before menopause.

The findings held after considering numerous factors that could affect heart health, including waist circumference, blood pressure, lipids, smoking status, physical activity levels and financial stress. What should readers take away from your report?

Response: The findings add to growing evidence that menopause is a time for critical changes in cardiovascular health and underscore the importance of women and their doctors focusing on heart health during the menopausal transition. Frequent monitoring of cardiovascular risk factors may be prudent, particularly in black women who are at even greater risk earlier in the menopausal transition. What recommendations do you have for future research as a result of this work?

Response: As our study was not able to tell why we’re seeing these changes during the menopause transition, future research should test whether the known dramatic hormonal changes accompanying menopause play a role in vascular health either by increasing inflammation or affecting vascular fat deposition.

Additionally, clinical trials will be needed to test if lifestyle interventions, such as changes to diet or physical activity; medications, such as statins or hormone replacement therapy; or even increased screening and tracking of measures of heart health could be beneficial as women go through menopause. Is there anything else you would like to add?

Response: Additional authors on this research include Karen A. Matthews, Ph.D., Maria M. Brooks, Ph.D., Emma Barinas-Mitchell, Ph.D., and Jared W. Magnani, M.D., M.Sc., all of Pitt; Imke Janssen, Ph.D., of Rush University; and Steven M. Hollenberg, M.D., of Cooper University Hospital.

This research was funded by National Institutes of Health grants U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, HL065581 and HL065591.

Any disclosures?

There are no direct conflicts of interest. However, Dr. Brooks serves as a DSMB member for Cerus Corporation.


Arterial Stiffness Accelerates Within 1 Year of the Final Menstrual Period

Saad Samargandy, Karen A. Matthews, Maria M. Brooks, Emma Barinas-Mitchell, Jared W. Magnani, Imke Janssen, Steven M. Hollenberg, Samar R. El Khoudary
Originally published23 Jan 2020
Arteriosclerosis, Thrombosis, and Vascular Biology. ;0:ATVBAHA.119.313622







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Last Updated on February 5, 2020 by Marie Benz MD FAAD