Objective: To evaluate the influence of menopause and hormone replacement t
herapy (HRT) on weight and the effect of weight gain on coronary risk facto
rs.
Design: From 1991 to 1992 cardiovascular risk factors were assessed in 271
premenopausal women between the ages of 40 and 53 years. The women were not
receiving HRT at that time. Five years later, these women were reevaluated
.
Results: Weight and body mass index (BMI) increased steadily with age. Duri
ng the observation period there was an average increase of 4.0 kg +/- 4.6 (
p < 0.0001), Women who experienced menopause and those who did not experien
ce menopause had a similar weight increase (3.8 +/- 4.4 kg vs. 4.3 +/- 4.8,
p = 0.37). Likewise, weight gain was similar in those who did or did not u
se HRT (nonusers, 4.3 +/- 4.6 kg; users, 3.5 +/- 3.7 kg; ex-users, 3.4 +/-
5.8 kg). At their first checkups, overweight women and obese women already
had significant differences in their risk factors, including higher systoli
c pressure (p < 0.02), diastolic pressure (p < 0.01), glucose (p < 0.02) an
d triglycerides (p < 0.0001), and lower high-density lipoprotein cholestero
l (p < 0.004) as compared with women of normal weight. Unexpectedly, women
of normal weight who became overweight or obese during the monitoring perio
d did not show any deterioration in their risk factors.
Conclusions: During the perimenopausal period there is a weight gain that d
oes not seem to depend on the menopause or HRT. Being overweight or obese d
uring the menopausal transition is not necessarily associated with deterior
ation in coronary risk factors. This seems to imply the existence of differ
ent metabolic populations within this group of women.