Menopause Associated with elevated Coronary Artery Calcium Score: Study

Menopause and ageing deteriorate the metabolic profile, but little is known about how they independently contribute to structural changes in coronary arteries.

A group of researchers from Brazil conducted a study to compare a broad cardiometabolic risk profile of women according to their menopausal status and investigated if menopause per se is associated with the presence of coronary artery calcium (CAC) in the ELSA-Brasil.

All participants, except perimenopausal women, who had menopause <40 years or from non-natural causes or reported use of hormone therapy were included. The sample was stratified according to menopause and age categories (premenopause ≤45 years, premenopause >45 years, and postmenopause); their clinical profile and computed tomography-determined CAC were compared using Kruskal–Wallis and chi-squared test for frequencies. Associations of CAC (binary variable) with menopause categories adjusted for traditional and nontraditional covariables were tested using logistic regression.

The results of the study are as follows:

· From 2,047 participants 51 ± 9 years of age, 1,175 were premenopausal and 872 were postmenopausal women.

· Mean values of anthropometric variables, blood pressure, lipid and glucose parameters, branched-chain amino acids (BCAA), and homeostasis model assessment (HOMA-IR), as well as frequencies of morbidities, were more favourable in premenopausal, particularly in younger ones.

· In crude analyses, CAC >0 was associated with triglyceride-rich lipoprotein remnants, dense low-density lipoprotein, BCAA, and other variables, but not with HOMA-IR.

· Menopause was independently associated with CAC >0 when compared to the younger premenopausal group.

Thus, the researchers concluded that associations of menopause with CAC, independent of traditional and non-traditional cardiovascular risk factors suggest that hormonal decline per se may contribute to calcium deposition in coronary arteries.

Reference:

Menopause Per se Is Associated with Coronary Artery Calcium Score: Results from the ELSA-Brasil by Fonseca, M et. al published in the Journal of Women's Health

https://doi.org/10.1089/jwh.2021.0182