The severity of risk factors for heart disease, diabetes and stroke appears to increase more rapidly in the years leading up to menopause—especially among African-American women, according to a new study.
The risk factors, together known as metabolic syndrome, include a large waistline, high triglyceride (a blood fat) levels, low HDL “good” cholesterol levels, high blood pressure and high blood sugar when fasting.
“Previous research showed that after menopause, women were at much greater risk for metabolic syndrome than before menopause began,” said Mark DeBoer, M.D., a professor of pediatric endocrinology at the University of Virginia in Charlottesville. “This latest study indicates that the increased risk observed earlier may be related more to the changes happening as women go through menopause and less to the changes that take place after menopause.”
Researchers analyzed the records of 1,470 black and white women in the Atherosclerosis Risk in Communities Study, a national study of the causes and health effects of hardening of the arteries. They selected participants based on whether they went through menopausal changes over a 10-year period.
After considering hormone replacement therapy and other factors that might bias results, researchers found:
- Women experienced rapid increases in metabolic syndrome severity during the last years of pre-menopause and the transition years to menopause, known as perimenopause.
- African-American women experienced a much more rapid increase in metabolic syndrome severity before menopause, but a slower rate of increase after menopause, than white women.
- African-American women had higher rates of metabolic syndrome, particularly high blood pressure and high fasting blood sugar levels, than white women at the beginning of the study.
The findings confirm many previous studies that show black women are at greater risk for cardiovascular disease and diabetes than white women.
The results should also prompt physicians and other health-care providers to motivate women to make lifestyle changes to reduce risk factors, Dr. DeBoer said.
“The years transitioning to menopause may represent a ‘teachable moment,’ when patients are especially receptive to learning and putting into practice healthy habits that can make a difference in their cardiovascular disease risk,” he said.