Pre- and Early Peri-menopausal Physical Function and Risk of Cardiovascular Events: The Study of Women's Health Across the Nation

Overview

Journal J Aging Health

Publisher Sage Publications

Specialty Geriatrics

Date 2022 Oct 17

PMID 36250945

Authors

Brittney S Lange-Maia

Samar R El Khoudary

Carolyn J Crandall

Yanyu Zhang

Carrie A Karvonen-Gutierrez

Kelley Pettee Gabriel

Bradley M Appelhans

Elsa S Strotmeyer

Kelly R Ylitalo

Kelly Karavolos

Howard M Kravitz

Sheila A Dugan

Imke Janssen

Affiliations

Soon will be listed here.

Abstract

Objectives: To determine whether physical function (PF) before menopause is related to cardiovascular disease (CVD) risk.

Methods: Participants were = 2950 pre-/early peri-menopausal women (median age 46, (25th-75th percentile: 43-48 years). Physical function was assessed at baseline using the Physical Function subscale of the SF-36 and scores were trichotomized (no, some, or substantial limitations). Clinical CVD events were ascertained at annual/biennial clinical assessments through the 15th follow-up visit. Risk of CVD was determined with Cox proportional hazards models. Women were followed for a median of 19.1 years, during which 220 women had a CVD event. In fully adjusted models, women with substantial limitations at baseline had higher CVD risk compared to women with no limitations (hazards ratio [HR] = 1.55, 95% confidence interval [CI]: 1.12-2.33). Substantial PF limitations in pre- and early peri-menopausal women are associated with higher risk of clinical CVD events, consistent with literature in older adults.

Citing Articles

Construction and Comparison of Machine Learning-Based Risk Prediction Models for Major Adverse Cardiovascular Events in Perimenopausal Women.

Chen A, Chang X, Bian X, Zhang F, Ma S, Chen X Int J Gen Med. 2025; 18():11-20.

PMID: 39801922 PMC: 11721002. DOI: 10.2147/IJGM.S497416.

References

Murray E, Hardy R, Strand B, Cooper R, Guralnik J, Kuh D . Gender and life course occupational social class differences in trajectories of functional limitations in midlife: findings from the 1946 British birth cohort. J Gerontol A Biol Sci Med Sci. 2011; 66(12):1350-9. PMC: 3210957. DOI: 10.1093/gerona/glr139. View

Keeney T, Fox A, Jette D, Jette A . Functional Trajectories of Persons with Cardiovascular Disease in Late Life. J Am Geriatr Soc. 2018; 67(1):37-42. PMC: 6705121. DOI: 10.1111/jgs.15584. View

Ylitalo K, Karvonen-Gutierrez C, Fitzgerald N, Zheng H, Sternfeld B, El Khoudary S . Relationship of race-ethnicity, body mass index, and economic strain with longitudinal self-report of physical functioning: the Study of Women's Health Across the Nation. Ann Epidemiol. 2013; 23(7):401-8. PMC: 3898343. DOI: 10.1016/j.annepidem.2013.04.008. View

McHorney C, Ware Jr J, Lu J, Sherbourne C . The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994; 32(1):40-66. DOI: 10.1097/00005650-199401000-00004. View

van den Borst B, Koster A, Yu B, Gosker H, Meibohm B, Bauer D . Is age-related decline in lean mass and physical function accelerated by obstructive lung disease or smoking?. Thorax. 2011; 66(11):961-9. PMC: 3285455. DOI: 10.1136/thoraxjnl-2011-200010. View

Levine D, Davydow D, Hough C, Langa K, Rogers M, Iwashyna T . Functional disability and cognitive impairment after hospitalization for myocardial infarction and stroke. Circ Cardiovasc Qual Outcomes. 2014; 7(6):863-71. PMC: 4241126. DOI: 10.1161/HCQ.0000000000000008. View

Luy M, Gast K . Do women live longer or do men die earlier? Reflections on the causes of sex differences in life expectancy. Gerontology. 2013; 60(2):143-53. DOI: 10.1159/000355310. View

Holland A, Wong E, Lauderdale D, Palaniappan L . Spectrum of cardiovascular diseases inAsian-American racial/ethnic subgroups. Ann Epidemiol. 2011; 21(8):608-14. PMC: 3215504. DOI: 10.1016/j.annepidem.2011.04.004. View

Wing R, Lang W, Wadden T, Safford M, Knowler W, Bertoni A . Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011; 34(7):1481-6. PMC: 3120182. DOI: 10.2337/dc10-2415. View

10.

Sowers M, Jannausch M, Gross M, Karvonen-Gutierrez C, Palmieri R, Crutchfield M . Performance-based physical functioning in African-American and Caucasian women at midlife: considering body composition, quadriceps strength, and knee osteoarthritis. Am J Epidemiol. 2006; 163(10):950-8. DOI: 10.1093/aje/kwj109. View

11.

El Khoudary S, Chen H, Barinas-Mitchell E, McClure C, Selzer F, Karvonen-Gutierrez C . Simple physical performance measures and vascular health in late midlife women: the Study of Women's Health across the nation. Int J Cardiol. 2015; 182:115-20. PMC: 4382424. DOI: 10.1016/j.ijcard.2014.12.042. View

12.

Pahor M, Guralnik J, Ambrosius W, Blair S, Bonds D, Church T . Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial. JAMA. 2014; 311(23):2387-96. PMC: 4266388. DOI: 10.1001/jama.2014.5616. View

13.

Thurston R, Aslanidou Vlachos H, Derby C, Jackson E, Brooks M, Matthews K . Menopausal Vasomotor Symptoms and Risk of Incident Cardiovascular Disease Events in SWAN. J Am Heart Assoc. 2021; 10(3):e017416. PMC: 7955448. DOI: 10.1161/JAHA.120.017416. View

14.

Sternfeld B, Ainsworth B, Quesenberry C . Physical activity patterns in a diverse population of women. Prev Med. 1999; 28(3):313-23. DOI: 10.1006/pmed.1998.0470. View

15.

El Khoudary S, Aggarwal B, Beckie T, Hodis H, Johnson A, Langer R . Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020; 142(25):e506-e532. DOI: 10.1161/CIR.0000000000000912. View

16.

Whelton P, Carey R . The 2017 American College of Cardiology/American Heart Association Clinical Practice Guideline for High Blood Pressure in Adults. JAMA Cardiol. 2018; 3(4):352-353. DOI: 10.1001/jamacardio.2018.0005. View

17.

Sergi G, Veronese N, Fontana L, De Rui M, Bolzetta F, Zambon S . Pre-frailty and risk of cardiovascular disease in elderly men and women: the Pro.V.A. study. J Am Coll Cardiol. 2015; 65(10):976-83. DOI: 10.1016/j.jacc.2014.12.040. View

18.

Beavers K, Beavers D, Nesbit B, Ambrosius W, Marsh A, Nicklas B . Effect of an 18-month physical activity and weight loss intervention on body composition in overweight and obese older adults. Obesity (Silver Spring). 2013; 22(2):325-31. PMC: 3880399. DOI: 10.1002/oby.20607. View

19.

Hulsmann M, Quittan M, Berger R, Crevenna R, Springer C, Nuhr M . Muscle strength as a predictor of long-term survival in severe congestive heart failure. Eur J Heart Fail. 2004; 6(1):101-7. DOI: 10.1016/j.ejheart.2003.07.008. View

20.

Inzitari M, Naydeck B, Newman A . Coronary artery calcium and physical function in older adults: the Cardiovascular Health Study. J Gerontol A Biol Sci Med Sci. 2008; 63(10):1112-8. PMC: 4886308. DOI: 10.1093/gerona/63.10.1112. View