Megan M Wenner, Ninette Shenouda, Leena Shoemaker, Andrew Kuczmarski, Katherine Haigh, Angelica Del Vecchio, Allyson Schwab, Shane J McGinty, David G Edwards, Ryan T Pohlig, Virginia R Nuckols, Lyndsey DuBose, Kerrie L Moreau
{"title":"Characterizing Vascular and Hormonal Changes in Women Across the Lifespan: A Cross-Sectional Analysis.","authors":"Megan M Wenner, Ninette Shenouda, Leena Shoemaker, Andrew Kuczmarski, Katherine Haigh, Angelica Del Vecchio, Allyson Schwab, Shane J McGinty, David G Edwards, Ryan T Pohlig, Virginia R Nuckols, Lyndsey DuBose, Kerrie L Moreau","doi":"10.1152/ajpheart.00373.2024","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Vascular dysfunction, marked by lower endothelial function and increased aortic stiffness, are non-traditional risk factors that precede the development of CVD. However, the age at which these changes in vascular function occur in women and the degree to which reproductive hormones mediate these changes has not been characterized.</p><p><strong>Methods: </strong>Women free from major disease were enrolled across the adult lifespan (aged 18-70, n=140). Endothelial function was assessed as flow-mediated dilation (FMD) of the brachial artery during reactive hyperemia using duplex ultrasound and expressed as percent dilation. Aortic stiffness was measured by carotid-femoral pulse wave velocity (cfPWV). Blood samples were obtained to quantify reproductive hormone concentration. Regression models determined age-related breakpoints and mediating factors between age and vascular outcomes.</p><p><strong>Results: </strong>FMD declined with age with a breakpoint and steeper decline occurring at age 47. Thereafter, age was independently associated with lower FMD (B=-0.13, P<0.001). cfPWV was relatively stable until a breakpoint at age 48, and age was independently associated with higher cfPWV thereafter (B=0.10, P<0.001). Path analysis revealed that the association between age and FMD was partially mediated by follicle stimulating hormone (<i>ab<sub>ind</sub></i>=0.051, P=0.01) and progesterone (<i>ab<sub>ind</sub></i>=0.513, P<0.001) but not estradiol (<i>ab<sub>ind</sub></i>=-0.004, P=0.08). No mediation was present for cfPWV.</p><p><strong>Conclusions: </strong>Age was associated with endothelial dysfunction and aortic stiffness in women beginning at 47 and 48 years, respectively, 3-4 years prior to the average age of menopause. The association between age and endothelial dysfunction was explained in part by elevations in follicle stimulating hormone and progesterone, but not declining estradiol.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":null,"pages":null},"PeriodicalIF":4.1000,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of physiology. Heart and circulatory physiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1152/ajpheart.00373.2024","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Vascular dysfunction, marked by lower endothelial function and increased aortic stiffness, are non-traditional risk factors that precede the development of CVD. However, the age at which these changes in vascular function occur in women and the degree to which reproductive hormones mediate these changes has not been characterized.
Methods: Women free from major disease were enrolled across the adult lifespan (aged 18-70, n=140). Endothelial function was assessed as flow-mediated dilation (FMD) of the brachial artery during reactive hyperemia using duplex ultrasound and expressed as percent dilation. Aortic stiffness was measured by carotid-femoral pulse wave velocity (cfPWV). Blood samples were obtained to quantify reproductive hormone concentration. Regression models determined age-related breakpoints and mediating factors between age and vascular outcomes.
Results: FMD declined with age with a breakpoint and steeper decline occurring at age 47. Thereafter, age was independently associated with lower FMD (B=-0.13, P<0.001). cfPWV was relatively stable until a breakpoint at age 48, and age was independently associated with higher cfPWV thereafter (B=0.10, P<0.001). Path analysis revealed that the association between age and FMD was partially mediated by follicle stimulating hormone (abind=0.051, P=0.01) and progesterone (abind=0.513, P<0.001) but not estradiol (abind=-0.004, P=0.08). No mediation was present for cfPWV.
Conclusions: Age was associated with endothelial dysfunction and aortic stiffness in women beginning at 47 and 48 years, respectively, 3-4 years prior to the average age of menopause. The association between age and endothelial dysfunction was explained in part by elevations in follicle stimulating hormone and progesterone, but not declining estradiol.
期刊介绍:
The American Journal of Physiology-Heart and Circulatory Physiology publishes original investigations, reviews and perspectives on the physiology of the heart, vasculature, and lymphatics. These articles include experimental and theoretical studies of cardiovascular function at all levels of organization ranging from the intact and integrative animal and organ function to the cellular, subcellular, and molecular levels. The journal embraces new descriptions of these functions and their control systems, as well as their basis in biochemistry, biophysics, genetics, and cell biology. Preference is given to research that provides significant new mechanistic physiological insights that determine the performance of the normal and abnormal heart and circulation.