Menopause and the characteristics of the large arteries in a population study

Staessen, Jan A.; Heijden-Spek, Janneke J. van der; Safar, Michel E.; Hond, Elly Den; Gąsowski, Jerzy; Fagard, Robert; Wang, J G; Boudier, H. A. J. Struijker; Bortel, Luc M. Van

doi:10.1038/sj.jhh.1001226

Cited by 90 publications

(68 citation statements)

References 39 publications

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“…4,8 -12,14,31,32 None of these studies determined how increases in arterial stiffness associated with IGM and DM-2 were driven by changes in distension, diameter, and pulse pressure. Additionally, our study is among the first 33 to estimate local pulse pressure by distension waveform calibration, which is more accurate than brachial pulse pressure. 21 Our data are in agreement with the Atherosclerosis Risk In Communities (ARIC) study, which also showed that DM-2 was associated with increased carotid stiffness.…”

Section: Discussionmentioning

confidence: 99%

Arterial Stiffness Increases With Deteriorating Glucose Tolerance Status

Henry

Kostense²,

Spijkerman³

et al. 2003

Circulation

432

385

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Background-Type 2 diabetes (DM-2) and impaired glucose metabolism (IGM) are associated with an increased cardiovascular disease risk. In nondiabetic individuals, increased arterial stiffness is an important cause of cardiovascular disease. Associations between DM-2 and IGM and arterial stiffness have not been systematically investigated. Methods and Results-In a population-based cohort (nϭ747; 278 with normal glucose metabolism, 168 with IGM, and 301 with DM-2; mean age, 68.5 years), arterial stiffness was ultrasonically estimated by distensibility and compliance of the carotid, femoral, and brachial arteries and by the carotid elastic modulus. After adjustment for age, sex, and mean arterial pressure, DM-2 was associated with increased carotid, femoral, and brachial stiffness, whereas IGM was associated only with increased femoral and brachial stiffness. .63) for femoral compliance. The brachial artery followed a pattern similar to that of the femoral artery. Increases in stiffness indices were explained by decreases in distension, increases in pulse pressure, an increase in carotid intima-media thickness, and, for the femoral artery, a decrease in diameter. Hyperglycemia or hyperinsulinemia explained only 30% of the arterial changes associated with glucose tolerance. Adjustment for conventional cardiovascular risk factors did not affect these findings. Conclusions-IGM and DM-2 are associated with increased arterial stiffness. An important part of the increased stiffness occurs before the onset of DM-2 and is explained neither by conventional cardiovascular risk factors nor by hyperglycemia or hyperinsulinemia.

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Section: Discussionmentioning

confidence: 99%

Arterial Stiffness Increases With Deteriorating Glucose Tolerance Status

Henry

Kostense²,

Spijkerman³

et al. 2003

Circulation

432

385

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“…It is thought that smooth muscle cell hypertrophy underlies increased IMT [16,17]; these structural alterations in smooth muscle then limit vascular dilatory capacity [38] as well. It is likely, then, that any structural benefits of HT underlying lumen diameter and IMT in the older HT women in the current study would translate into preserved dilation to an NO donor (i.e.…”

Section: Discussionmentioning

confidence: 99%

Hormone therapy is associated with preserved smooth muscle structure and dilation in the arterial vasculature of the leg in older women

2008

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Long-term hormone therapy (HT) is associated with reduced intima-medial thickness (IMT), an established risk factor for atherosclerotic disease, in the femoral artery of healthy older women relative to age-matched non-hormone users. However, the influence of continuous, long-term HT on the relation between age, IMT, and smooth muscle dilation has not been investigated in the popliteal artery, an artery prone to stiffening and calcification. In the present study, popliteal artery IMT and smooth muscle dilation (the increase in diameter to sublingual nitroglycerin, NTG) were assessed with Doppler ultrasound in young (Y: n=16; age 23 ± 1 [mean ± S.E.M]), older non-HT (O non-HT: n=14; age 69 ± 1), and older HT (O HT: n=8; age 67 ± 1) healthy women. The ∼0.5mm increase in resting diameter observed in older non-HT women relative to young women was absent in older HT women, as was the age-related increase in IMT (Y: 0.52 ± 0.02 mm; O non-HT: 0.63 ± 0.02 mm; O HT: 0.56 ± 0.02 mm; p < 0.05 for age and hormone comparisons). NTG dilation (percent change above rest) was similarly attenuated in older non-HT women (Y: 8.6 ± 1 %; O non-HT: 3.0 ± 0.7 %; O HT: 7.4 ± 1.7 %; p < 0.05 for age and hormone comparisons), and NTG dilation was inversely related to IMT (p < 0.01). Collectively, these results suggest that long-term, continuous HT may alleviate the detrimental effects of aging on both structural changes and smooth muscle dilation of the popliteal artery in healthy women.

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“…In women, the enlargement of the internal diameter and the fall in blood velocity are less marked (+3.3% and −10.7%, respectively), causing no modification in peak wall shear stress. Women have stiffer arteries at followup, and it is known that menopause per se may increase arterial stiffness (Staessen et al 2001). Increased arterial stiffness is associated with an increase in the propagation speed of waves, with augmentation of the interaction of the incident and reflected waves (O'Rourke and Hashimoto 2007;Nichols 2005;Sergers 2008).…”

Section: Discussionmentioning

confidence: 99%

Human common carotid wall shear stress as a function of age and gender: a 12-year follow-up study

Irace

Carallo

Franceschi

et al. 2011

AGE

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Hemodynamic forces play a role in the development of atherosclerosis. Their variations with age have been assessed in cross-sectional, but not longitudinal, studies. The aim of the present study was to investigate in both sexes the age-dependent change in wall shear stress and arterial stiffness in subjects studied twice 12 years apart. Forty-eight subjects (15 women and 33 men) were studied twice 12 years apart. Subjects underwent blood viscosity measurement and echo-Doppler of carotid arteries, from which the intima-media thickness (IMT) was measured and the wall shear stress and Peterson's elastic modulus were calculated. Blood viscosity increased in both sexes, more markedly in women (+13.2%) than men (+7.2%). Common carotid diameter increased in both sexes, but in men (+7.4%) more than in women (+5.5%). Peak and mean velocity decreased at follow-up by 10.7% and 18.9% in women and by 14.2% and 18.1% in men. Peak and mean shear stress significantly decreased in men by 13.0% and 17.5%, respectively, while in women only the mean shear stress was reduced (−11.8%). The IMT of the common carotid artery increased by 29% in women and 20% in men. Arterial stiffness significantly increased (+74.5% in women and +28.0% in men). The percent change in mean shear stress was significantly and inversely associated with the percent change in IMT. The data of this study show that, in a middle-aged population observed for almost 12 years, the mean shear stress decreases significantly in both sexes, while peak shear stress decreases significantly only in men. The change in mean shear stress is inversely associated with changes in IMT. Arterial stiffness, on the other hand, increases with aging.

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Menopause and the characteristics of the large arteries in a population study

Cited by 90 publications

References 39 publications

Arterial Stiffness Increases With Deteriorating Glucose Tolerance Status

Arterial Stiffness Increases With Deteriorating Glucose Tolerance Status

Hormone therapy is associated with preserved smooth muscle structure and dilation in the arterial vasculature of the leg in older women

Human common carotid wall shear stress as a function of age and gender: a 12-year follow-up study

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