Carotid IMT and stiffness, aortic stiffness and pulse pressure: association with hormone therapy in postmenopausal women: baseline findings from the CASHMERE trial
T Simon1, P Boutouyrie2, S Christin-Maitre1, A Gompel3, R Joanides4, A Kearny-Schwartz5, Ch Kuntz6, S Laurent2, B Pannier7, B Pornel8, HH Struijker-Boudier9, Ch Thuilliez4, L Van Bortel10, F Zannad5, I Pithois-Merli11 & P Jaillon1
Common carotid artery intima media thickness (CCA-IMT), aortic stiffness (carotid-femoral pulse wave velocity-PWV) and central pulse pressure (PP) are early markers of atherosclerosis. The influence of hormonal replacement treatment (HRT) on arterial parameters in menopausal women remains to be investigated.
We used baseline data of 665 menopausal women with hypercholesterolemia, screened for the CASHMERE study, a 12-month double-blind randomized trial comparing the effects of atorvastatin (80 mg/day) versus placebo, ±HRT, on the progression of CCA-IMT. CCA-IMT, PP, PWV were measured by using a high-definition echotracking device (Esaot®), aplanation tonometry (Sphygmocor®), and Complior® respectively. Mean age was 58±6 years with a mean duration of menopause (M) of 8±7 years. Age at M was 50±5 years. Among them, 17% were smokers, 23% had hypertension and 28% were HRTusers.
| ||CCA-IMT (μm)||Central PP (mmHg)||PWV (m/s)|
|Independent determinants||β coef.||R2 increment||P||β coef.||R2 increment||P||β coef.||R2 increment||P|
|Age at M (5 yrs)||25||2.9||<0.001||3.0||4.0||<0.001||0.4||4.7||<0.001|
|M duration (5 yrs)||25||4.8||<0.001||3.5||7.2||<0.001||0.6||12.4||<0.001|
|Current use of HT (yes)||−37||2.3||0.002||−2.7||0.9||0.003||−0.3||0.9||0.01|
|Mean BP (10 mmHg)|| ||||||7.0||32.4||<0.001||0.4||8.8||<0.001|
|Central PP (10 mmHg)||9||1.3||0.004|||||||||||||
R2: % of explained variance, β coef: slope of the multivariate correlation.
|Total R2|| ||13.2|| || ||48.3|| || ||24.0|| |
Conclusions: Duration and age at menopause were associated with thickening and stiffening of large arteries. Current users of HRT had significantly thinner and more distensible arteries than non users.