The menopausal transition is a stronger determinant of cardiovascular risk factors than chronologic age, and leisure-time physical activity may attenuate menopause-associated atherogenic changes in healthy middle-aged women, according to study results published in Frontiers in Endocrinology.

Risk for cardiovascular disease has a marked and rapid increase after the onset of menopause, and this is associated with several atherogenic changes.

The current study is part of the large-scale population-based cohort study Estrogenic Regulation of Muscle Apoptosis (ERMA), in which healthy women aged 47 to 55 years were included in both cross-sectional (886 patients) and longitudinal (193 patients) study designs. Researchers aimed to assess the differences in serum cardiovascular risk factors in premenopausal, perimenopausal, and postmenopausal women; examine changes in these risk factors over the menopausal transition; and explore the effects of leisure-time physical activity.

Comprehensive questionnaires, laboratory visits, anthropometric measurements, and physical activity data by self-report and accelerometers were used to characterize the menopausal groups, and serum lipid profiles were analyzed to quantify cardiovascular risk.

In the cross-sectional ERMA population, serum total cholesterol concentrations were significantly higher in the postmenopausal group compared with the other groups (P <.001). Total cholesterol levels were higher in the perimenopausal group compared with the premenopausal group (P <.050). Serum low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) concentrations followed similar trends (P <.001). These trends were also seen in the longitudinal ERMA population.

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Self-reported leisure-time physical activity (metabolic equivalent task [MET]-h/d) was found to be an independent predictor of serum cardiovascular risk factors. In the cross-sectional ERMA population, self-reported leisure-time physical activity was positively associated with HDL-C and negatively associated with all other measured serum cardiovascular risk markers, except for total cholesterol. The results were similar in the longitudinal ERMA population, with leisure-time physical activity being positively associated with HDL-C and negatively associated with triglyceride, LDL-C, and fasting blood glucose levels. These associations were independent of chronologic aging.

The study had several limitations, including the lack of prospective, patient-centered outcomes, such as cardiovascular event incidence or mortality. In addition, the ERMA population was comprised entirely of white women.

“Based on our findings, [leisure-time physical activity] may attenuate menopause-associated atherogenic changes in the serum [cardiovascular] risk factors of healthy middle-aged women. However, [leisure-time physical activity] does not seem to entirely offset the lipid profile changes associated with the menopausal transition,” wrote the researchers.

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Reference

Karvinen S, Jergenson MJ, Hyvärinen M, et al. Menopausal status and physical activity are independently associated with cardiovascular risk factors of healthy middle-aged women: cross-sectional and longitudinal evidence. Front Endocrinol. 2019;10:589.