Cerebral and peripheral vascular differences between pre- and postmenopausal women.

Objective: Menopause is associated with lower peripheral vascular function; however, cerebrovascular responses to this time-period are unclear. We aimed to describe peripheral vascular and cerebrovascular differences between pre- and postmenopausal women.

Methods: Fifty pre- and postmenopausal women (N = 100) underwent assessments of cerebral blood flow; cerebrovascular reactivity and autoregulation; carotid artery reactivity; brachial and femoral artery flow-mediated dilation; and carotid, brachial, and femoral artery intima-media thickness. Comparisons were made between pre- and postmenopausal women followed by a secondary analysis (N = 20) between late premenopausal women and those within 5 years of menopause using a general linear model.

Results: Cerebral blood flow (-11 [-17, -4 cm/s]; P = 0.03) and carotid reactivity (-2.3 [-4.3, -0.3%] P = 0.03) were lower postmenopause compared to premenopause, whereas cerebrovascular reactivity and autoregulation did not differ (P > 0.05). Postmenopausal women had a larger carotid (0.16 [0.13, 0.20 mm] P < 0.001), brachial (0.07 [0.03, 0.11 mm] P = 0.004), and femoral artery intima-media thickness (0.09 [0.05, 0.14 mm] P = 0.04), alongside lower brachial (-2.3 [-3.9, -0.7%] P = 0.004) and femoral artery flow-mediated dilation (-3.0 [-4.3, -1.8%] P < 0.001). In the secondary-analysis, early postmenopausal women had a lower femoral artery flow-mediated dilation (-1.9 [-3.9, -0.0%] P = 0.05) and larger carotid intima-media thickness (0.07 [0.00, 0.14 mm] P = 0.03) compared to late premenopausal women.

Conclusions: Cerebral blood flow, carotid artery reactivity, peripheral vascular function, and structure are negatively affected by age. Preliminary data indicate that femoral artery function and carotid artery structure may be potentially impaired in early postmenopause compared with late premenopause. These findings suggest that conduit arteries susceptible to atherosclerosis may be important targets for lifestyle intervention in early menopause.