Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
BMC Women's Health
Published in: BMC Women's Health 1/2018

Open Access 01-12-2018 | Research article

Flow mediated vasodilation compared with carotid intima media thickness in the evaluation of early cardiovascular damage in menopausal women and the influence of biological and psychosocial factors

Authors: Mauricio Sanchez-Barajas, Lorena del Rocio Ibarra-Reynoso, Marco Antonio Ayala-Garcia, Juan Manuel Malacara

Published in: BMC Women's Health | Issue 1/2018

Login to get access

Abstract

Background

Women after menopause increase risk for cardiovascular disease and several factors may be related. The purpose was to study biological and psychosocial factors associated with early cardiovascular damage in pre- and postmenopausal women, assessed with carotid intima-media thickness vs flow-mediated dilatation.

Methods

Women 45 to 57 years old were grouped in the pre- (n = 60), early (n = 58) and late post-menopause (n = 59). Anthropometric, metabolic and hormonal data were registered, as well as measures of depression, anxiety, submission, perceived stress, and sleep alterations. Heart Rate Variability was recorded to obtain the information regarding sympathovagal balance. Carotid intima-media thickness and flow-mediated dilatation were assessed by ultrasound. Two-way ANOVA and multiple regression model were used.

Results

At late postmenopause, the carotid intima-media was thicker (p < 0.001) and flow-mediated dilatation decreased (p < 0.001). Carotid intima-media thickness was associated positively with age (p < 0.001), submission score (p = 0.029), follicle stimulating hormone levels (p < 0.001), and body mass index (p = 0.009). Flow-mediated dilatation was associated only with age (p < 0.001). Regarding heart rate variability, the time domain pNN50 measurement was higher in premenopausal women (p = 0.001), Low Frequency (LF) was higher in the two groups of postmenopausal (p = 0.001) and High Frequency (HF) higher in the early postmenopausal women (p = 0.042).

Conclusions

Under our conditions carotid intima-media thickness had higher predictive value for early cardiovascular damage at menopause. The finding of the association of the submission score, indicates de influence of stress on vascular damage.
Literature
1.
Dalal PK, Agarwal M. Postmenopausal syndrome. Indian J Psychiatry. 2015;57(suppl 2):222–32.CrossRef
2.
Jafari F, Hadizadeh MH, Zabihi R, et al. Comparison of depression, anxiety, quality of life, vitality and mental health between premenopausal and postmenopausal women. Climateric. 2014;17(6):660–5.CrossRef
3.
Aguilar-Zavala H, Pérez-Luque Elva L, Luna-Martínez F, et al. Symptoms at postmenopause: genetic and psychosocial factors. Menopause. 2012;19(10):1140–5.CrossRef
4.
Adibfar A, Saleem M, Lanctot KL, et al. Potential biomarkers for depression associated with coronary artery disease: a critical review. Curr Mol Med. 2016;16(2):137–64.CrossRef
5.
Wong JM, Na B, Regan MC, et al. Hostility, health behaviors, and risk of recurrent events in patients with stable coronary heart disease: findings from the heart and soul study. J Am Heart Assoc. 2013;2(5):e000052.CrossRef
6.
Lloyd-Jones D, Adams RJ, Browm TM, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2010- update: a report from the American Heart Association. Circulation. 2010;121(7):e46–e215.CrossRef
7.
Sowers M, Zheng H, Tomey K, et al. Changes in body composition in women over six years at midlife: ovarian and chronological aging. J Clin Endocrinol Metab. 2007;92(3):895–901.CrossRef
8.
Matthews K, Meilahn E, Kuller LH, et al. Menopause ad risk factors of coronary heart disease. N Engl J Med. 1989;321(10):641–6.CrossRef
9.
da Silva LH, Panazzolo DG, Marques MF, et al. Low-dose estradiol and endothelial and inflammatory biomarkers in menopausal overweight/obese women. Climateric. 2016;19(4):337–43.CrossRef
10.
Rossi R, Nuzzo A, Origliani G, et al. Prognosis role of flow-mediated dilation and cardiac risk factors in post-menopausal women. J Am Coll Cardiol. 2008;51(10):997–1002.CrossRef
11.
Santoro N, Sutton-Tyrrell K. The SWAN song: study of Women’s health across the Nation’s recurringthemes. Obstet Gynecol Clin N Am. 2011;38(3):417–23.CrossRef
12.
Agewall S. Is impaired flow-mediated dilatation of brachial artery a cardiovascular risk factor? Curr Vasc Pharmacol. 2003;1(2):107–9.CrossRef
13.
Benjamin EJ, Larson MG, Keyes MJ, et al. Clinical correlates and heritability of flow-mediated dilation in the community: the Framingham heart study. Circulation. 2004;109(5):613–9.CrossRef
14.
Lorenz MW, Markus HS, Bots M, et al. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation. 2007;115(4):459–67.CrossRef
15.
Santos-Garcia D, Rodriguez-Yañez M, Arias-Rivas S, et al. Brachial arterial flow mediated dilation: utility in clinical and experimental practice. Rev Neurol. 2011;53(6):351–60.PubMed
16.
Gurses KM, Tokgozoglu L, Yalcin MU, Kocyigit D, Dural M, Canpinar H, Yorgun H, Sahiner ML, Kaya EB, Akin S, Gurlek A, Guc D, Aytemir K. Markers of subclinical atherosclerosis in premenopausal women with vitamin D deficiency and effect of vitamin D replacement. Atherosclerosis. 2014;237(2):784–9.CrossRef
17.
Bechlioulis A, Kalantaridou SN, Naka KK, Chatzikyriakidou A, Calis KA, Makrigiannakis A, Papanikolaou O, Kaponis A, Katsouras C, Georgiou I, Chrousos GP, Michalis LK. Endothelial function, but not carotid intima-media thickness, is affected early in menopause and is associated with severity of hot flushes. J Clin Endocrinol Metab. 2010;95(3):1199–206.CrossRef
18.
Lambrinoudaki I, Kazani A, Armeni E, Rizos D, Augoulea A, Kaparos G, Alexandrou A, Georgiopoulos G, Kanakakis I, Stamatelopoulos K. The metabolic syndrome is associated with carotid atherosclerosis and arterial stiffness in asymptomatic, nondiabetic postmenopausal women. Gynecol Endocrinol. 2018;34(1):78–82.CrossRef
19.
Halaris A. Inflammation-associated co-morbidity between depression and cardiovascular disease. Curr Top Behav Neurosci. 2017;31:45–70.CrossRef
20.
Eller NH, Malmberg B, Bruhn P. Heart rate variability and intima media thickness. Int J Behav Med. 2006;13(3):201–13.CrossRef
21.
Sánchez-Barajas M, Figueroa-Vega N, Ibarra-Reynoso L, Del R, et al. Influence of heart rate variability and psychosocial factors on carotid stiffness, elasticity and impedance at menopause. Arch Med Res. 2015;46(2):118–26.CrossRef
22.
Soules MR, Sherman S, Parrott E, et al. Executive summary: stages of reproductive aging workshop (STRAW) Park City, Utah, July, 2001. Menopause. 2001;8(6):402–7.CrossRef
23.
García CR, Aguilar ZH, Malacara JM. Symptoms at menopause and care of grandchildren. Climateric. 2010;13(5):492–8.CrossRef
24.
Licht RW, Qvitzau S, Allerup P, et al. Validation of the Bech-Rafaelsen melancholia scale and the Hamilton depression scale in patients with major depression; is the total score a valid measure of illness severity? Acta Psychiatr Scand. 2005;111(2):144–9.CrossRef
25.
Garay-Sevilla ME, Malacara JM, González-Contreras E, et al. Perceived psychological stress in diabetes mellitus type 2. Rev Investig Clin. 2000;52(3):240–5.
26.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.CrossRef
27.
Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1(1):27–41.CrossRef
28.
Macías-Robles M, Fernández-López JA, Hernández-Mejía R, et al. Measuring psychosocial stress at work in Spanish hospital’s personnel. Psychometric properties of the Spanish version of effort-reward imbalance model. Med Clin. 2003;120(17):652–7.CrossRef
29.
Allan S, Gilbert P. A social comparison scale: psychometric properties and relationship to psychopathology. Personal Individ Differ. 1995;19:293–9.CrossRef
30.
Heart rate variability. Standards of measurement, physiological interpretation and clinical use. Task force of the European Society of Cardiology and the north American Society of Pacing and Electrophysiology. Eur Heart J. 1996;17(3):354–81.CrossRef
31.
Perakakis P, Koffly M, Taylor M, et al. KARDIA: a Matlab software for the analysis of cardiac interbeat intervals. Comput Methods Prog Biomed. 2010;98(1):83–9.CrossRef
32.
Gamelin FX, Berthoin S, Baquet G. Validity of the polar S810 heart rate monitor to measure R-R intervals at rest. Med Sci Sports Exerc. 2006;38(5):887–93.CrossRef
33.
Gamelin FX, Baquet G, Berthoin S, et al. Validity of the polar S810 to measure R-R intervals in children. Int J Sports Med. 2008;29(2):134–8.CrossRef
34.
Vanderlei LC, Silva RA, Pastre CM, et al. Comparison of the polar S810i monitor and the ECG for the analysis of heart rate variability in the time and frequency domains. Braz J Med Biol Res. 2008;41(10):854–9.CrossRef
35.
Corretti MC, Anderson TJ, Benjamin EJ, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol. 2002;39(2):257–65.CrossRef
36.
Celermajer DS, Sorensen KE, Bull C, et al. Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol. 1994;24(6):1468–74.CrossRef
37.
Roman MJ, Naqvy TZ, Gardin JM, et al. American society of echocardiography report. Clinical application of noninvasive vascular ultrasound in cardiovascular risk stratification: a report from the American Society of Echocardiography and the society for vascular medicine and biology. Vasc Med. 2006;11(3):201–11.CrossRef
38.
Touboul PJ, Hennerici MG, Meairs S, et al. Mannheim carotid intima-media thickness consensus (2004-2006). Cerebrovasc Dis. 2007;23(1):75–80.CrossRef
39.
Nyberg M, Seidelin K, Andersen TR, et al. Biomarkers of vascular function in premenopausal and recent postmenopausal women of similar age: effect of exercise training. Am J Physiol Regul Integr Comp Physiol. 2014;306(7):R510–7.CrossRef
40.
Collins P, Webb CM, de Villiers TJ, et al. Cardiovascular risk assessment in women - an update. Climateric. 2016;19(4):329–36.CrossRef
41.
Maturana MA, Irigoyen MC, Spritzer PM. Menopause, estrogens, and endothelial dysfunction: current concepts. Clinics (Sao Paulo). 2007;62(1):77–86.CrossRef
42.
Moddithaya S, Avadhany ST. Comparison of cardiac autonomic activity between pre and postmenopausal women using heart rate variability. Indian J Physiol Pharmacol. 2009;53(3):227–34.
43.
Gao L, Wu X, Zhu X, et al. Follicle-stimulating hormone associates with metabolic factors in postmenopausal women. Gynecol Endocrinol. 2018;27:1–4.CrossRef
44.
Virdis A, Ghiadoni L, Pinto S, et al. Mechanisms responsible for endothelial dysfunction associated with acute estrogen deprevation in normotensive women. Circulation. 2000;101(19):2258–63.CrossRef
45.
Augustine AL, Lefferts WK, Dowthwaite JN, et al. Subclinical atherosclerosis risk in endurance-trained premenopausal amenorrheic women. Atherosclerosis. 2016;244:157–64.CrossRef
46.
Jarpa C, Pineda V, Manterola C. Thickness of carotid intima-media as a predictor of cardiovascular events. Systematic review of the literature. Int J Morphol. 2013;31(1):293–300.
47.
Kotsis VT, Stabouli SV, Papamichael CM, et al. Impact of obesity in intima media thickness of carotid arteries. Obesity (Silver Spring). 2006;14(10):1708–15.CrossRef
48.
Koskinen J, Kähönen M, Viikari JS, et al. Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the cardiovascular risk in young Finns study. Circulation. 2009;120(3):229–36.CrossRef
49.
Maher V, O'Dowd M, Carey M, et al. Association of central obesity with early carotid intima-media thickening is independent of that from other risk factors. Int J Obes. 2009;33(1):136–43.CrossRef
50.
Dalmas E, Kahn JF, Giral P, et al. Intima-media thickness in severe obesity: links with BMI and metabolic status but not with systemic or adipose tissue inflammation. Diabetes Care. 2013;36(11):3793–802.CrossRef
51.
Shively CA, Clakson TB. Social status and coronary artery atherosclerosis in female monkeys. Arterioscler Thromb. 1994;14(5):721–6.PubMed
52.
Varleta P, Concepción R, Vargas P, et al. Association of carotid intima-media thickness with traditional cardiovascular risk and metabolic factors. Rev Med Chil. 2013;141(6):695–703.CrossRef
53.
Do KA, Green A, Guthrie JR, et al. Longitudinal study of risk factors for coronary heart disease across the menopausal transition. Am J Epidemiol. 2000;151(6):584–93.CrossRef
Metadata
Title
Flow mediated vasodilation compared with carotid intima media thickness in the evaluation of early cardiovascular damage in menopausal women and the influence of biological and psychosocial factors
Authors
Mauricio Sanchez-Barajas
Lorena del Rocio Ibarra-Reynoso
Marco Antonio Ayala-Garcia
Juan Manuel Malacara
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2018
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-018-0648-3

Other articles of this Issue 1/2018

BMC Women's Health 1/2018 Go to the issue

Research article

The relationship between under-five child death and maternal mental distress in Gamo Gofa Zone, Southern Ethiopia: a community based comparative cross-sectional study

Research article

Depression, sexual dysfunction and sexual quality of life in women with infertility

Research article

Patterns of missing data in the use of the endometriosis symptom diary

Research article

A community-based qualitative study on the experience and understandings of intimate partner violence and HIV vulnerability from the perspectives of female sex workers and male intimate partners in North Karnataka state, India

Research article

Surmounting difficulties to provide home based neonatal care – reflections of community health workers

Research article

Listening to their voices: understanding rural women’s perceptions of good delivery care at the Mibilizi District Hospital in Rwanda