The effect of menopause on blood lipid and lipoprotein levels

There is increasing evidence from epidemiological studies that exogenous es trogen (hormone replacement therapy) protects against the elevated risk of cardiovascular disease in women after the menopause. However, it is still u ncertain whether the postmenopausal decrease in endogenous estrogen in itse lf contributes significantly to this increase in risk. Most of the studies that have provided evidence linking cardiovascular disease with menopause h ave involved North American women, who may differ significantly from Europe ans in terms of lifestyle and diet. I:ICARUS (Italian Climacteric Research Group Study) is an observational study that involves Italian Menopause Clin ics, with the objective of collecting observational data on menopause and i ts management. The results of a cross-sectional analysis of 9309 women, fre e from any hormonal treatment and enrolled up to March 1997, are reported h ere. Data show that the menopause has a marked effect on the circulating le vels of lipids and lipoproteins. From pre- to post-menopause there are sign ificant increases in total cholesterol (6.9% before and 4.4% after adjustme nt for covariates including chronological age, educational level, center, B MI, smoking habits, hypertension and diabetes, previous contraceptive use, and time since menopause), LDL (7.5% before, 4.0% after), and triglycerides (9.0% before, 3.2% (ns) after). However, there is no significant change in HDL. Among postmenopausal women, no effect on lipid profile of time since menopause was observed. (C) 1999 Elsevier Science Ireland Ltd. All rights r eserved.