Relation of dehydroepiandrosterone and dehydroepiandrosterone sulfate withcardiovascular disease risk factors in women: Longitudinal results from the Massachusetts women's health study

Low circulating levels of the adrenal steroids dehydroepiandrosterone (DHEA ) and dehydroepiandrosterone sulfate (DHEAS) are thought to be associated w ith increased risk of cardiovascular disease (CVD) in men. In women, either a positive or null association with CVD has been found. The nature of the relation between DHEAS and CVD risk factors in women is unclear and is base d on cross-sectional data. We present results from a longitudinal investiga tion of serum DHEA and DHEAS and cardiovascular disease risk factors in 236 women, initially 50-60 years old, from a population-based prospective (198 6-1995) study of the menopausal transition. We used generalized estimating equations to model the relation of serum DHEA and DHEAS to systolic and dia stolic blood pressure and serum levels of total cholesterol, high density l ipoprotein cholesterol, and apolipoproteins A and B, adjusting for other fa ctors related to CVD. Both DHEA and DHEAS were positively related to diasto lic and systolic blood pressure, and DHEAS was negatively related to apolip oprotein A. DHEA and DHEAS were also positively related to smoking, alcohol use, estrone, and estradiol levels, and inversely related to age. Our resu lts suggest that higher levels of DHEA and DHEAS in middle-aged women may i ndicate increased CVD risk. J CLIN EPIDEMIOL 52;2:95-103, 1999. (C) 1999 El sevier Science Inc.