PREVALENCE AND DETERMINANTS OF CAROTID ATHEROSCLEROSIS IN HEALTHY POSTMENOPAUSAL WOMEN

Background and Purpose Subclinical atherosclerosis in the carotid arte ries can be assessed noninvasively with B-mode ultrasound. Few studies have included enough younger postmenopausal women to examine risk fac tors specific to this group that were related to subclinical carotid a therosclerosis. Methods A subgroup of 200 participants of the Healthy Women Study underwent B-mode ultrasound of the carotid arteries. Intim a-media thickness (IMT) and focal plaque were assessed in each carotid artery. Data regarding risk factors, including blood pressure paramet ers, lipid values, body mass index, smoking history, and hormone statu s, were collected at three separate time points (before menopause, 1 y ear after menopause, and 5 or 8 years after menopause). Results The me an IMT was 0.76+/-0.11 mm, and 50% of the population had at least one focal plaque. Smoking had the strongest association with the presence of plaque. Women who smoked al the time of the ultrasound evaluation h ad five times the odds of having at least one focal plaque compared wi th women who had never smoked (95% confidence interval, 2.0 to 13.0; P less than or equal to.01). After we controlled for age and years afte r menopause, premenopausal values of pulse pressure (P less than or eq ual to.05), LDL cholesterol (P less than or equal to.05), and a histor y of smoking (P less than or equal to.01) were independently predictiv e of plaque. Premenopausal values Df triglycerides, pulse pressure, an d ever smoking were independently related to average IMT after we cont rolled for age and years after menopause. Conclusions This study has p rovided valuable information about the prevalence of carotid atheroscl erosis and the risk factors related to carotid atherosclerosis in a gr oup of healthy postmenopausal women.