High HDL levels in menopausal women may not be cardioprotective
Postmenopausal women with high levels of high-density lipoproteins (HDL) did not have the same cardioprotective benefits typically seen in women of other ages, researchers reported in the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology.
“The results of our study are particularly interesting to both the public and clinicians because total HDL cholesterol is still used to predict cardiovascular disease risk,” said lead author Samar R. El Khoudary, PhD, MPH, of the University of Pittsburgh in a prepared statement. “This study confirms our previous work on a different group of women and suggests that clinicians need to take a closer look at the type of HDL in middle-aged and older women, because higher HDL cholesterol may not always be as protective in postmenopausal women as we once thought. High total HDL cholesterol in postmenopausal women could mask a significant heart disease risk that we still need to understand.”
El Khoudary and colleagues hypothesized physiological changes in menopausal women, including a reduction of estrogen in the body and other metabolic changes, could trigger chronic inflammation that would change the quality of HDL particles, thereby not making HDL cardioprotective.
The study included 1,138 postmenopausal women between the ages of 45 and 84 who were enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA), as part of the final study cohort. The researchers examined the number and size of the HDL particles and the total cholesterol within the HDL particles.
They found higher HDL levels were associated with increased atherosclerosis risk in post-menopausal women. This was markedly higher in women who reached menopause at an older age and had been post-menopausal for at least 10 years.
El Khoudary and colleagues also found high amounts of large HDL particles close to the occurrence of menopause were associated with an increased risk of cardiovascular disease (CVD). However, they also found high levels of HDL particles were associated with a lower risk of atherosclerosis.
As the cohort continued to move further away from the initial menopause transition, the researchers found HDL grew cardioprotective again.
“Identifying the proper method to measure active ‘good’ HDL is critical to understanding the true cardiovascular health of these women,” said senior author Matthew Budoff, MD, of the Los Angeles Biomedical Research Institute.
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.