'Test for heart risk before menopause'

High blood pressure can predict heart problems

Tests to determine whether a woman is at risk of heart disease or stroke are more accurate if carried out before the menopause, research suggests.

The chance of developing heart disease or stroke in later life can be predicted by measuring known risk factors such as cholesterol levels and blood pressure.

But scientists from the University of Pittsburgh have found that to be of great use these tests need to be carried out before a woman goes through the menopause.

Prevention efforts should begin when a women is in her 40s or even younger

Dr Karen Matthews, University of Pittsburgh

Lead researcher Dr Karen Matthews said tests carried out before the menopause reflected the state of the cardiovascular system over many years.

However, tests carried out in the years following the menopause were a reflection of changes that had only recently taken place in the body.

The researchers evaluated 372 women who completed examinations before menopause and again at one and five years after their menstrual cycles stopped.

Tests

The exams included measurements of cholesterol, blood pressure, glucose, body weight, and body mass index (a measure of whether a person is overweight for their height).

The postmenopausal exam included an ultrasound test to see if the arteries had thickened - a major symptom of heart disease.

It was found that women who had elevated cholesterol, higher blood pressure and increased body weight before the menopause also had increased thickening of the blood vessels after the menopause.

However, none of the changes in risk factors during the early postmenopause period were associated with formation of the fatty plaques that lead to thickening of the arteries.

The risk of heart disease and stroke increases after menopause in part because oestrogen production decreases.

Prevention strategies urged

Doctors often step up efforts to encourage postmenopausal women to adopt habits and treatments that may ward off heart disease and stroke.

But Dr Matthews said prevention strategies should start a lot earlier.

She said: "This suggests that we can look relatively early, before the onset of symptoms, to see who is at high risk.

"Prevention efforts should begin when a women is in her 40s or even younger, so we don't have to deal with lots and lots of people who are very ill later in life."

More research

A British Heart Foundation spokesman said: "This research is interesting but it is only based on a small sample of 372 women.

"More randomised studies over longer periods need to be conducted to establish if testing really is more accurate before menopause."

He added that there is a considerable amount of evidence that women become more prone to cardiovascular risk factors that cause heart disease and stroke after the menopause.

Recent statistics show that women in the 45-55-age bracket are three times more likely to develop coronary heart disease than women in the 35-44-age bracket.

Eoin Redahan, of the Stroke Association, said: "Stroke accounts for more deaths in women than breast cancer, and we would recommend that women of any age take measures against this serious condition."

The research is published in the Stroke: Journal of the American Heart Association.