NEW YORK (Reuters Health) - As women begin to enter menopause, their risk
of developing a collection of heart disease risk factors appears to climb, a
study has found.
Researchers found that among 949 U.S. women followed for nearly a decade, the
risk of developing metabolic syndrome increased during perimenopause -- the
years during which a woman's body begins to transition into menopause, usually
starting somewhere in her 40s.
Metabolic syndrome refers to this cluster of risk factors for heart disease,
stroke and diabetes -- including high blood pressure, abdominal obesity, high
blood sugar, low levels of "good" HDL cholesterol and high triglycerides
(another type of blood fat). The syndrome is usually diagnosed when a person has
three or more of these traits.
The new findings, published in the Archives of Internal Medicine, appear to be
the first showing that the incidence of metabolic syndrome begins to rise during
perimenopause.
More specifically, the study found, the risk is related to increases in
testosterone activity.
The "main message" here for women is that maintaining a healthy lifestyle may be
especially critical during perimenopause, lead researcher Dr. Imke Janssen, of
Rush University Medical Center in Chicago, told Reuters Health.
Not smoking, eating a healthy diet and getting regular exercise can all help
reduce a woman's risk of the various components of metabolic syndrome, Janssen
said.
She and her colleagues based their findings on an ethnically diverse sample of
U.S. women who were between the ages of 42 and 52 and free of metabolic syndrome
at the outset. The women were followed for nine years.
Overall, Janssen's team found, nearly 14 percent developed metabolic syndrome by
the time they had their final menstrual period. The risk of developing the
syndrome increased progressively starting six years before the final menstrual
period.
But while the odds of developing metabolic syndrome were elevated after
menopause, the risk was greater during perimenopause, Janssen noted.
It has long been known that women generally have a lower risk of cardiovascular
disease than men do before the age of 45. But after age 55, the trend reverses,
with women actually being at greater risk than men their age.
"Obviously, something happens there, between 45 and 55," Janssen said, noting
that it was once assumed that diminishing levels of estrogen told the whole
story.
But in this study, women's estrogen levels were unrelated to the odds of
developing the metabolic syndrome. Instead, the syndrome correlated with an
increase in testosterone activity -- suggesting that the direct negative effects
of testosterone are more important than the loss of estrogen's positive effects
in women's cardiovascular risks.
This idea, Janssen and her colleagues note, is consistent with clinical trials
that have found no cardiovascular benefits from estrogen replacement therapy.
The bottom line for women, according to Janssen, is that during these years of
hormonal change, healthy habits become more important than ever.
SOURCE: Archives of Internal Medicine, July 28, 2008.
