According to the American College of Cardiology, stiffness of the carotid arteries, the vessels in the neck that supply blood to the brain, is associated with cardiovascular events such as stroke and heart attacks. A number of studies have found that carotid arteries tend to stiffen around the time of menopause. A new study, the Los Angeles Atherosclerosis Study, has found that receiving hormone replacement therapy (HRT) during transition into the menopause can improve carotid artery distensibility; thus, reducing this stiffening. The findings were published in the February edition of the journal Menopause.
The study authors note that studies have suggested that arterial distensibility decreases during menopause; however, its relationship with HRT remains controversial. Therefore, they studied distensibility and hormone therapy use at different menopause stages. The study group comprised 161 women ranging in age from 42 to 61 years without cardiovascular disease. The subjects underwent carotid artery measurements by ultrasound to calculate distensibility index at baseline and three years later. Menopause stage was classified at each visit as premenopausal, perimenopausal, or postmenopausal. During the three years of observation, the women were classified as remaining premenopausal, remaining postmenopausal, or transitioning (defined as change from premenopausal to perimenopausal, from premenopausal to postmenopausal, from perimenopausal to perimenopausal, or from perimenopausal to postmenopausal).
The researchers found that distensibility declined over time at all menopause stages. Compared to postmenopausal women, premenopausal and transitioning/no HRT women had more than twice the decrease in distensibility index; however, transitioning/HRT women did not differ in distensibility decline. In addition, change in systolic blood pressure and change in pulse pressure were independent predictors of distensibility index change. Women in the premenopausal and transitioning/no HRT groups had a significantly faster decrease in distensibility index compared to postmenopausal women; however, the transitioning/hormone therapy group did not.
The authors concluded that their findings confirm that the menopausal transition is associated with decreased carotid artery distensibility. HRT is associated with better arterial distensibility only during the menopausal transition. They recommended that additional prospective (forward-looking) studies should be conducted to confirm these findings and to determine whether hormone therapy use beyond the menopausal transition is related to distensibility.