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No association of menopause and hormone replacement therapy with carotid artery intima-media thickness. Atherosclerosis Risk in Communities (ARIC) Study Investigators.

TitleNo association of menopause and hormone replacement therapy with carotid artery intima-media thickness. Atherosclerosis Risk in Communities (ARIC) Study Investigators.
Publication TypeJournal Article
Year of Publication1996
AuthorsNabulsi AA, Folsom AR, Szklo M, White A, Higgins M, Heiss G
JournalCirculation
Volume94
Issue8
Pagination1857-63
Date Published1996 Oct 15
ISSN0009-7322
KeywordsCarotid Arteries, Cross-Sectional Studies, Estrogen Replacement Therapy, Female, Humans, Male, Menopause, Middle Aged, Postmenopause, Prospective Studies, Time Factors, Tunica Intima, Tunica Media, Ultrasonography
Abstract

BACKGROUND: Cardiovascular disease is the major cause of death in older women. Information on the relation of menopause and hormone replacement therapy with carotid atherosclerosis is limited.

METHODS AND RESULTS: We examined cross-sectionally the association of menopausal status, years since last menstruation, and hormone replacement therapy status with carotid artery intima-media thickness as determined by B-mode ultrasound. Female participants (n = 5436) in the Atherosclerosis Risk in Communities Study without a history of symptomatic cardiovascular disease were included in the analyses. Menopause status in 45- to 54-year-old women who had never used hormone replacement therapy was not strongly associated with carotid intima-media thickness (mean = 0.65 mm and 0.67 mm in premenopausal and postmenopausal women, respectively, adjusted for age, race, cigarette years of smoking, body mass index, sport index, systolic blood pressure, use of blood pressure medications, drinking status, diabetes, and education level). In postmenopausal women aged 55 to 64 years, women with 5 years since last menstruation (0.75 mm) (P > .05). Although hormone replacement therapy use was associated with a more favorable lipid and hemostasis profile than nonuse, its use was not associated with intima-media thickness in postmenopausal women aged 55 to 64 years (adjusted average = 0.74 mm for current users of estrogen alone and approximately 0.75 mm each for current users of estrogen plus progestin, former users, and never users).

CONCLUSIONS: The data suggest that the well-known associations of hormone replacement therapy with reductions in atherosclerotic cardiovascular disease may be attributable more to acute physiological effects, such as hemodynamic changes or reduced thrombosis, than to atherosclerosis itself.

DOI10.1161/01.cir.94.8.1857
Alternate JournalCirculation
PubMed ID8873660
Grant ListN01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States