Journal article
The menopausal transition period and cardiovascular risk
Nature reviews cardiology, v 21(3), pp 203-211
01 Mar 2024
PMID: 37752349
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The menopausal transition period spans, on average, 2-8 years before the final menstrual period and is associated with an increase in clinical and subclinical cardiovascular risk. In this Review, we discuss the metabolic and cardiovascular changes that occur during the menopausal transition period and the role of ovarian ageing, chronological ageing and other ageing-related risk factors in mediating these changes. Disentangling the relative contributions of chronological and reproductive ageing to cardiovascular risk is challenging, but data from longitudinal studies in women transitioning from premenopause to post-menopause have provided valuable insights. We also discuss evidence on how cardiovascular risk is altered by premature or early menopause, surgical menopause, and vasomotor and other menopausal symptoms. Whether targeted interventions can slow the progression of atherosclerosis and subclinical disease during the menopausal transition, thus delaying or preventing the onset of cardiovascular events, remains to be determined. Furthermore, we consider the recommended strategies for cardiovascular risk reduction in women undergoing menopausal transition using the framework of the American Heart Association's Life's Essential 8 key measures for improving and maintaining cardiovascular health, and discuss the cardiovascular risks and benefits of menopausal hormone therapy. Finally, we also discuss novel therapies that might benefit this population in reducing cardiovascular risk.
The menopausal transition period, which begins with irregular menstrual cycles and ends with the final menstrual period, is associated with an increase in cardiovascular risk. In this Review, Mehta and Manson describe the metabolic and cardiovascular changes that occur during the menopausal transition period and summarize the evidence on the use of targeted interventions to slow the progression of atherosclerosis.
The menopausal transition period heralds a dynamic change in a woman's reproductive lifespan and is associated with substantial hormonal, metabolic and cardiovascular changes.Some of the cardiometabolic changes that occur throughout the menopausal transition period are independent of chronological ageing and are instead largely driven by reproductive ageing.Individuals who undergo premature menopause, early menopause or surgically induced menopause have an increased risk of adverse cardiometabolic changes.Strategies to reduce the cardiometabolic risk during the menopausal transition period include lifestyle modifications and pharmacological therapy.Depending on the timing of initiation, menopausal hormone therapy might portend neutral-to-beneficial cardiometabolic effects during the menopausal transition period.
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Details
- Title
- The menopausal transition period and cardiovascular risk
- Creators
- Jaya M. Mehta - Allegheny General HospitalJoAnn E. Manson - Harvard University
- Publication Details
- Nature reviews cardiology, v 21(3), pp 203-211
- Publisher
- NATURE PORTFOLIO
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:001072279300001
- Scopus ID
- 2-s2.0-85172656653
- Other Identifier
- 991021937657104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems