Women who develop thick waists and high cholesterol
at menopause may be at higher risk of heart disease
because they also have more damage to their arteries,
U.S. researchers reported.
They believe their findings may help explain why
older women who took hormone replacement therapy had
higher rates of heart attacks and strokes. They also
may offer the possibility that younger women can safely
take HRT if they want to.
Menopausal women who had more abdominal fat and
higher cholesterol, already linked with heart disease,
also appeared to be experiencing more oxidative stress,
Kerrie Moreau of the University of Colorado at Boulder
and colleagues reported.
Both circumstances are known to be linked with
heart disease but this is the first time the two have
been specifically linked to one another, Moreau said
in a telephone interview.
"We know arteries become stiffer when we get older.
We were trying to figure out why that is," Moreau
said.
"One mechanism is the development of oxidative
stress -- free radicals that can damage cells in our
body. We were able to pinpoint what type of post-menopausal
women this is associated with. Those women who have
more body fat accumulation in the abdominal region
appeared to have more oxidative stress."
After menopause many women undergo a shift in body
fat so that there is more fat in the abdomen. This
can cause the sympathetic nervous system, which controls
blood vessel function, to become elevated and stiffen
the arteries.
And because the women are no longer producing estrogen,
a natural antioxidant, they begin to suffer from artery
disease, Moreau proposed.
TESTING OXIDATIVE STRESS
Moreau and colleagues studied 31 healthy, sedentary
women and found that the arteries of women past menopause
were 56 percent less elastic than those of premenopausal
women.
They tested oxidative stress by giving the women
intravenous infusions of ascorbic acid -- better known
as vitamin C and a powerful antioxidant.
When the postmenopausal women were given ascorbic
acid, elasticity in their carotid arteries improved
by about 26 percent, Moreau's team reports in the
American Heart Association
journal Hypertension.
Moreau stresses that the effects of the vitamin
C are temporary and that the body quickly excretes
the high levels used in her study.
What it may show is that estrogen therapy may help
prevent some of this damage, if used before it happens.
"We can't say you should take estrogen," she stressed.
But several researchers have noted that the studies
that were the basis of pulling millions of women off
hormone replacement therapy included women with an
average age of 65 -- well past menopause and perhaps
suffering from already damaged arteries.
"Chances are the vessels are already aged and they
could be getting stiffer," Moreau said.
"When we give hormone therapy to an unhealthy vessel,
it can actually cause bad things to happen. So maybe
if you initiate hormone therapy in a healthy vessel,
right around the age of menopause, we could probably
see some different things."
She agrees with others who want to investigate the
possibility that HRT given to younger women, just
going through menopause at 45 to 55, might prevent
the damage. Some women who have severe symptoms such
as hot flashes may opt for HRT, and watching their
health years later may give an answer.