London – New data show that women in perimenopause (the transition period with cycle irregularities until menopause, when periods stop) have changes in their cholesterol profile that could have a negative impact on their cardiovascular health. Researchers are discussing this at the 47th Congress of the European Society of Cardiology (ESC) [1,2].
“We found an increase in ‘bad’ low-density lipoprotein particles (LDL) and a decrease in ‘good’ high-density lipoprotein particles (HDL),” says study author Dr. Stephanie Moreno from the University of Texas Southwestern Medical Center, Dallas. “The changes indicate that menopause is associated with a transition to a riskier lipoprotein profile.” This increases the risk of cardiovascular diseases such as coronary heart disease.
Different CHD risks in women and men
Background: Cardiovascular diseases are the most common cause of death in women: 40% of all deaths are due to them. Although cardiovascular diseases occur on average 10 years later in women than in men, the risk increases significantly after menopause.
The mechanisms behind this have so far been poorly researched. However, scientists have shown that changes in lipid profiles occur during perimenopause. Previous studies have focused heavily on LDL and HDL cholesterol without examining subfractions or particle numbers of these molecules in detail.
Temporal changes in lipid profiles in focus
A recent study has filled this gap. A total of 1,246 participants in the Dallas Heart Study (DHS) with known menopausal status were measured for common lipoproteins associated with cardiovascular risk, including atherogenic LDL particles and small dense LDL particles (sdLDL), an LDL subtype that is considered more atherogenic than average LDL particles. In addition, 1,346 men with an average age of 43 years were included in the study as a reference group.
The participants had a mean age of 42 years in the peri-group, 54 years in the post-group and 34 years in the pre-group. Of all the participants, 440 (35%) were pre-menopausal, 298 (24%) peri-menopausal and 508 (41%) post-menopausal. The median follow-up period was 7 years.
Using magnetic resonance imaging, the scientists compared changes in lipoprotein levels between men and pre-, peri- and postmenopausal women. Their most important results:
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They observed the largest percentage change in total lipoprotein values at 8.3% between the peri- and post-group of women.
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Compared to men, the post-treatment group of women showed the largest percentage change in HDL-P of minus 4.8%.
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The percentage change in low-density LDL was largest in the peri group compared to men at 213%.
“We found that menopause is associated with adverse changes in lipoprotein profiles, with the most pronounced changes being an increase in ‘bad’ LDL particles and subfractions in perimenopause women,” commented Moreno. “The changes may help explain the increase in cardiovascular disease in postmenopausal women.”
