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Menopausal status and haemostatic variables
Insights
Postmenopausal women have a higher risk of ischaemic heart disease (IHD) due to elevated levels of factor VIIC and fibrinogen. These haemostatic differences contribute significantly to the increased IHD risk observed in older women.
Area of Science:
- Cardiovascular Health
- Menopause Research
- Haemostasis and Thrombosis
Background:
- Ischaemic heart disease (IHD) incidence is notably higher in postmenopausal women compared to age-matched premenopausal women.
- Haemostatic function differences between these groups are hypothesized to contribute to the disparity in IHD risk.
Purpose of the Study:
- To investigate the role of haemostatic function differences in the increased IHD risk observed in postmenopausal women.
- To compare levels of specific coagulation factors and lipids between premenopausal and postmenopausal women.
Main Methods:
- The Northwick Park Heart Study (NPHS) cohort, comprising 833 White women, was analyzed.
- Mean levels of factor VIIC, fibrinogen, and cholesterol were measured and compared between premenopausal and postmenopausal participants.
Main Results:
- Postmenopausal women exhibited 6-10% higher mean levels of factor VIIC, fibrinogen, and cholesterol compared to premenopausal women.
- After adjusting for inter-variable associations, the significant difference in cholesterol levels between the groups diminished.
- Factor VIIC and fibrinogen differences, however, remained significant.
Conclusions:
- Elevated levels of factor VIIC and fibrinogen in postmenopausal women are associated with increased IHD risk.
- These haemostatic changes may account for approximately 40% of the increased risk of fatal IHD in postmenopausal women compared to premenopausal women.
Abstract:
The incidence of ischaemic heart disease (IHD) is higher in postmenopausal women than in premenopausal women of the same age. The difference may be partly explicable in terms of differences between premenopausal and postmenopausal women in haemostatic function. This possibility has been studied in 833 White women in the Northwick Park Heart Study (NPHS). Mean levels of factor VIIC, fibrinogen, and cholesterol were between 6% and 10% higher in postmenopausal women than in premenopausal women of the same age. When allowances were made for associations between these variables, the difference between the two groups in cholesterol was no longer evident. By analogy with NPHS data on men, the differences in factor VIIC, fibrinogen, and cholesterol would increase the risk of fatal IHD in postmenopausal women by about 40% compared with the risk in premenopausal women of the same age.