Changes in levels of LDLc (bad cholesterol) from pre- to post-menopausal examinations are not as good at predicting the amount of coronary calcification in post-menopausal women as measures of LDLc taken pre-menopausally at age 47, according to Lewis Kuller, M.D., Dr.P.H., in a report to the 39th annual Conference on Cardiovascular Disease Epidemiology and Prevention, March 26, in Orlando, Fla.
"Even though LDLc increases about 20 mg/dL between pre-menopause and the eighth year post-menopause, the LDLc levels at age 47 are the best determinant of risk. There is a very strong association of LDLc at age 47 and coronary calcifications discovered at age 59," said Dr. Kuller, "Thus it is very important that pre-menopausal women know their cholesterol levels."
Dr. Kuller continued, "It is possible to prevent the development of the underlying cause of heart disease in women by reducing risk factors prior to menopause. Even perfectly healthy pre-menopausal women should have their risk factor levels evaluated, and they should make an all-out effort to reduce their level of risk."
Dr. Kuller's group enrolled approximately 200 participants beginning in the mid-1980s. The investigators performed eight follow-up evaluations of risk factors, including coronary calcification measurements using electron beam computed tomography (EBCT). The eighth evaluation was performed 11 years later, postmenopausally. EBCT is an imaging procedure that measures coronary and aortic calcifications, known markers for increased risk for coronary events.
"Just as important, it is probably misleading to use LDLc levels taken
after age 47 to determine what type of therapy a woman should receive to protect
her against heart disease," remarked Dr. Kuller, principal investigator on the
Healthy Women Study and chairman of the department of epidemiology at the
University of Pittsburgh's Graduate School of Public Health. "We found that the
Contact: Franki Williams
University of Pittsburgh Medical Center