Cardiovascular risk status and primary prevention in postmenopausal women: the MENOCARD study

OBJECTIVE: Our aim was to evaluate the usefulness of screening for cardiovascular risk factors and the effect of applying professional guidelines for risk reduction in postmenopausal women, as judged by the Framingham and the high-risk systematic coronary risk evaluation (SCORE) methods. METHODS: 18 menopause clinics in Hungary participated in the study, enrolling a total of 2789 patients. Physicians were asked to follow professional guidelines for the primary prevention of cardiovascular disease. Patients were requested to attend follow-up every four months for 12 months. RESULTS: The mean age of the patients was 56.7 +/- 6.9 years, and the time elapsed since the last menstrual period was 9.2 +/- 7.2 years. Overall, 29.4% of patients attended at least one follow-up visit. At the initial visit, high total cholesterol level (> 5 mmol/l) was detected in 78% of patients, high triglyceride level (> 1.7 mmol/l) in 29%, high systolic and/or diastolic blood pressure (> 140/90 mmHg) in 32%, fasting plasma glucose level > 6.1 mmol/l in 15%. Increased waist circumference (> 88 cm) was found in 85.8% of the patients; 18.3% of the patients smoked, which did not change. After 12 months, all laboratory parameters and the blood pressure had improved significantly. Both the Framingham and SCORE systems showed a significant improvement in the cardiovascular risk status, and the rate of metabolic syndrome had decreased significantly by the end of the study. CONCLUSIONS: Screening postmenopausal women for cardiovascular risk and the application of professional guidelines for primary prevention may significantly reduce the risk of coronary artery disease in this group. Patient compliance with follow-up visits needs improvement.