Background: Postmenopausal women are found to have increased prevalence of cardiovascular diseases (CVD) due to aging and loss of protective effects of estrogen. It is essential to screen these women to facilitate early detection. Awareness, education & timely intervention can help in minimizing the morbidity and mortality in this group. In this study we tried to actually measure the burden of such risk factors in our region because such data is scarce compared to developed nations.

Methods: This cross-sectional, observational study was conducted in Lata Mangeshkar Hospital, Nagpur. (M.S.) for a period of 2 years. 100 postmenopausal women were studied for cardiometabolic risk factors after fulfilling inclusion & exclusion criteria, by detailed clinical examination & laboratory tests. Statistical analysis was done by an expert using SPSS software v15.Chi square test was applied to derive statistical difference.

Results: The mean age of study population was 57±5.4 yrs. A large proportion (51%) of subjects were illiterate. Majority of women (59%) belonged to low socioeconomic strata of the society. Mean age of menopause in our subjects was 47.2±1.2 yrs. 57% women belonged to light physical activity group.

49% women were in overweight BMI category, 13% were obese & only 32% had normal BMI. Total 56% women had dysglycemia & diabetic status was newly detected in 14% of them. In 57% subject’s hypertension was detected for first time. Dyslipidemia was seen in 35% women. In total 35% subjects fulfilled criteria of metabolic syndrome.6% asymptomatic women were detected to be hypothyroid.

In 6% women coronary artery disease (CAD) was diagnosed by history, ECG& 2D-Echocardiography.

Conclusion: There is clustering of cardiometabolic risk factors in postmenopausal women which predisposes them to hazards of cardiovascular diseases.(CVD) This study emphasises the importance of early & regular screening of these women  to reduce the burden of CVD related morbidity & mortality. The awareness programmes, education of women with changes of lifestyle & timely intervention can help in achieving the goal.

Keywords: Postmenopausal women, Cardiometabolic risk factors, Cardiovascular Diseases, metabolic syndrome.

1. Gaziano TA, Gaziano JM. Epidemiology of cardiovascular disease.. Kasper DL, Hauser SL. Jameson JL, editors. Harrison’s principles of Medicine, 19^th edition New York: McGraw Hill, 2016; p.266e1-266e5.
2. Gupta R. Coronary heart disease in India: From epidemiology to action .Fortis Medical J.2009;2:9-18
3. World Health Organization. Non-communicable diseases country profiles. Geneva: World health organization; 2014. Available from: http://www.who.int/nmh/publications/ncd- profiles-2014/en
4. Prabhakaran D, Jeemon P, Roy A. Cardiovascular diseases in India current epidemiology and future directions. Circulation. 2016:133:1605-1620.
5. Jackson G. Gender differences in cardiovascular disease prevention. Menopause International. 2008;14 (1):13-17.
6. Lori M, et al. Cardiovascular diseases in women. Circulation, 1997;96:2468-2482
7. Lawlor DA, Ebrahim S, Davey SG. Sex matters. Secular & geographical trends in sex, differences in coronary artery disease mortality.BMJ.2001;323(7312):541-545.
8. Pilote L, Dasgupta K, et al. Comprehensive view of sex-specific issues related to cardiovascular diseases. CMAJ.2007;176(6):S1-S44.
9. Carr MC. The emergence of the metabolic syndrome with menaopause. J Clin Endocrinol Metab.2003;88:2404-2411.
10. Pohelman ET, Toth MJ, Gardener AW. Channges in energy balance and body composition at menopause: a controlled longitudinal study. Ann Intern Med.1995;123: 673-675.
11. Vander LJ, Annemarie M, et al. Age related differences in abdominal fat distribution in premenopausal and postmenopausal women with cardiovascular disease. menopause: 2013; 20(4):409-417.
12. WHO Research on the menopause. WHO technical report series 866. Geneva: World health Organization; 1996. Available  from: http://apps.who.int/iris/bitstream/10665/41841/1/WHO_TRS_866.pdf.
13. Mendelsohn ME, Karas RH. The protective effects of estrogen on cardiovascular system. N Engl J Med.1999;340:1801-11.
14. Taddei S, Virdis A, Ghiadoni L, et al. Menopause is associated with endothelial dysfunction in women. 1996; 28:576-582.
15. Yamamoto A, Honbe H, Mabuchi H, et al. Analysis of serum lipid levels in Japnese men and women according to BMI. Increase in risk of atherosclerosis in postmenopausal women. Research group on serum survey. Atherosclerosis. 1999;143(1):55-73.
16. Tchernof A, Calles-Escandon J, Sites CK. Menopause. central body fatness and insulin resistance; effects of hormone replacement therapy. Coronary A disease. 1998;9(8):503-11.
17. Florence A, Tremollieres, et al. Coronary heart disease risk factors & menopause: a study in 1684 French women. Atherosclerosis. 1999;142(2):415-23.
18. Rosano GM, Vitale C, Marazzi G, Volterrani M. Menopause & cardiovascular disease: The evidence. Climacteric. 2007;10:19-24.
19. Sharma S, Tandon VR, Mahajan A. Menopause & cardiovascular disease. JK 2008;10:1-2.
20. SharmaS,BakshiR,TandonVR,Mahajan A, Postmenopausal obesity. JK Sci 2008;10: 105-6.
21. Tandon VR, Mahajan A, Sharma S, Sharma A. Prevalence of cardiovascular risk factors in postmenopausal women: A rural study. J Midlife Health.2010;1(1):26-29.
22. Dosi R, Bhatt N, Shah P, Patel R. Cardiovascular disease and menopause. J Clin Diagn Res.2014;8(2):62-64.
23. Dasgupta S, Salman M, Lokesh S, DX Aviour, SYaseen Saheb et al. Menopause versus aging: The predictor of obesity & metabolic aberrrations among menopausal women of Karnataka, South India. J Midlife health.2012;3(1):24-30.
24. Chandiok K, Joshi S, Mondal PR. Menopausal status & cardiometabolic risk: A cross sectional study from Haryana state, India. Hum Biol Rev.2016;5(1):104-116.
25. Anjaly N, Viswanath L, Philip TA. Assess the knowledge on menopausal self care among perimenopausal women. J South Asian Feder Menopause Soc.2014;2(2):55-58.
26. Maturana MA, Franz RF, Metazdorf M, et al. Subclinical cardiovascular disease in postmenopausal women with low/medium cardiovascular risk by Framingham risk score. Maturitas.2015;81(2):311-316.
27. Stori KL, Kuller LH, Kriska AM, etal. Physical activity & Coronary artery calcification in two cohorts of women representing early & late menopause. 2010;17(6):1146-1151.
28. La H, PaC, Morocho N, Alvarado M, Chavez D. The metabolic syndrome among postmenopausal women in Ecuador. Gynecol Endocrinol. 2006; 22(8):447-5429.
29. Bulliyya G. Risk of coronary heart disease in women after menopause. J Indian Med Assoc.2001;99(9):478-80,482.
30. Singh YP. Tobacco & metabolic syndrome. Indian J Endocrinol Metab.2012;16(1):81-87.
31. Scillaci G, Verdecchia P, Borgioni C, Ciucci A. Early cardiac changes after menopause. Hypertension.1998; 32:764-769.
32. Cagnacci A, Cannoletta M, Palma F. Menopausal symptoms & risk factors for cardiovascular disease in postmenopause. Climacteric. 2012;15 (2):157-162.
33. Biondi B, Klein I .Hypothyroidism as a risk factor for cardiovascular disease. Endocrine. 2004;24(1):1-13.

Neelima Saoji