The onset of symptoms of coronary heart disease in women are displaced a decade compared with men after menopause, but currently there are reports in which 1 in 4 women is less than 59 years, suggesting that in the pre-menopausal period there is marked progression of vascular disease. Therefore we evaluated the presence of atherosclerotic disease in primary care menopausal women. Additionally, we hypothesized that the strict control of the traditional risk factors is not enough to prevent vascular disease progression.
Methods, post-menopausal women without cardiovascular events from Argentina were evaluated. Framingham risk score with body mass index (FRSbmi) and carotid ultrasound were employed for the evaluation. Carotid total plaque area (TPA) by ultrasound was determined as previously described by Spence et al (Stroke 2002;33;2916-2922). Additionally, LDL cholesterol (LDL), triglycerides (Trig) and HbA1c were measured. All determinations were done on day 1 and after 8 months of treatment. Only patients who achieved all the therapeutic goals (blood pressure (BP)<130/80mmHg, LDL<100mg/dl, Trig<140mg/dl, HbA1c5mm2, stable group, TPA changed 5mm2. In the presence of controlled of traditional risk factors, 50% of the population continued to progressive atherosclerotic disease (Table).
Conclusion, these results indicate that in the presence of controlled traditional risk factors, atherosclerosis may progress in some patients, including in menopausal women. Additional promoters of atherosclerosis should be evaluated in these progressive patients or possibly more intensive treatment should be used in such patients.