Early onset of menopause is associated with increased peripheral atherosclerotic plaque volume and progression

Background and aims: Cardiovascular disease (CVD) is the leading cause of death in western countries. One risk factor unique to women is the menopausal status. The aim of this study was to analyse the influence of the onset of menopause (MP) on the extent and progression of atherosclerotic plaque volume (PV). Methods: Postmenopausal women with at least one cardiovascular risk factor (CVRF) but without established CVD were included. Quantification of PV was performed in peripheral arteries using a three - dimensional (3D) ultrasound (US) technique. Follow-up examination to assess PV progression was performed after 19 (+/- 8) months. Results: 110 consecutive postmenopausal women (mean age 65.5) were included. Females with an earlier onset of MP (< 45 years) had a significantly higher PV than those with an intermediate (45-52 years) or later onset of menopause (> 52 years), irrespective of other CVRF (244 mm(3) vs. 193 mm(3) vs. 73 mm(3), respectively, p = 0.023). In addition, women with an earlier onset of MP had a higher PV progression compared to women with an intermediate or late onset (40 mm(3) vs. 35 mm(3) vs. 8.5 mm(3); p = 0.002, respectively). Moreover, these results were confirmed in multivariate regression, where only onset of MP (OR 0.88; 95%CI 0.81-0.96; p = 0.004) and age (OR 1.06; 95%CI 1.08-1.13; p = 0.025) were significant predictors for a higher atherosclerotic progression. Conclusions: An earlier onset of MP was associated with an increase in atherosclerotic PV and accelerated progression, independent of other CVRF.