High-density lipoprotein cardio-protection function deteriorates as women transition through menopause: The SWAN HDL Study.

Background: Women show a rise in HDL cholesterol efflux capacity (CEC) as they traverse menopause. Whether this rise is associated with a lower risk of cardiovascular disease (CVD) overtime is not clear.

Objectives: We tested whether CEC association with subclinical vascular health, measured using a composite subclinical vascular health score based on levels of carotid-intima media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), and presence of coronary artery calcium (CAC score >10), varies by time relative to the final menstrual period (FMP).

What Happens After Menopause (WHAM)? A Progress Report of a Prospective Controlled Study of Women After Pre-Menopausal Risk-Reducing Bilateral Salpingo-Oophorectomy.

Surgical menopause, the removal of both ovaries prior to natural menopause, may impact short-and long-term physical and emotional health. An increasingly common cause of surgical menopause is risk-reducing salpingo-oophorectomy (RRSO) in those at high inherited risk of ovarian cancer. The WHAM (What Happens After Menopause?) study is the largest prospective controlled study of RRSO.

Prospective associations of American Heart Association Life's Essential 8 with subclinical measures of vascular health, cardiovascular disease events, and all-cause mortality in women traversing menopause: The Study of Women's Health Across the Nation study.

Objectives: We aimed to characterize cardiovascular health status as measured by Life's Essential 8 (LE8) in midlife women and to test the associations between baseline and change since baseline in LE8 with subclinical measures of vascular health, cardiovascular disease (CVD) events, and all-cause mortality.

Methods: Baseline and follow-up LE8 metrics (diet, physical activity, nicotine exposure, sleep, body mass index, lipids, glucose, and blood pressure) were calculated as total and component scores. Changes in LE8 were calculated as differences between follow-up and baseline scores.

The mobile health intervention for rural patients with atrial fibrillation a randomized controlled trial.

Background: Rural individuals with atrial fibrillation (AF) experience challenges to anticoagulation adherence and self-management of the condition. We tested an intervention to improve anticoagulation adherence, quality of life, and health care utilization in rural individuals with AF.

Methods: We randomized rural patients with AF receiving anticoagulation to receive a smartphone-based relational agent (for disease education and adherence guidance) and a heart rate and rhythm monitor for 4 months or a smartphone-based health education app.

Protocol for a global menopause priority setting partnership.

Introduction: All those born with functioning ovaries will eventually experience menopause, and many will be symptomatic. However, significant gaps in the evidence base for menopause care remain. This National Institute for Health and Care Research James Lind Alliance Menopause Priority Setting Partnership (MAPS) will engage with clinicians and those with lived experience globally to determine the leading priorities for future menopause research.

The Relation between Systemic Inflammation and the Menopause Transition: The Study of Women's Health Across the Nation.

Objective: The menopause transition (MT) may substantially contribute to increased systemic inflammation in later life, regardless of aging. We characterized inflammation trajectories over the MT and determined their associations with premenopausal obesity and race/ethnicity.

Methods: Data comprising 15 follow-up visits from SWAN participants who had a known date of their final menstrual period (FMP) and at least three measures of high-sensitivity C-reactive protein (hs-CRP) (n=1470) or interleukin 6 (IL-6) (n=779) were evaluated using group-based trajectory modeling and piecewise linear mixed-effects models.

Association Between Cigarette Smoking and Subclinical Markers of Cardiovascular Harm.

Background: Cigarette smoking is a strong risk factor for cardiovascular harm.

Objectives: The study sought to explore the detailed relationships between smoking intensity, pack-years, and time since cessation with inflammation, thrombosis, and subclinical atherosclerosis markers of cardiovascular harm.

Methods: We included 182,364 participants (mean age 58.

Using a Composite Summary of Daily Sex Hormones to Gauge Time Until Menopause: A Focus on Pregnanediol Glucuronide (PDG).

Context: The timing of a woman's final menstrual period (FMP) in relation to her age is considered a valuable indicator of overall health, being associated with cardiovascular, bone health, reproductive, and general mortality outcomes.

Objective: This work aimed to evaluate the relationship between hormones and the "time to FMP" when daily hormone trajectories are characterized by their 1) entropy, and 2) deviation from premenopausal/stable cycle patterns (representing a textbook "gold standard"; GS).

Methods: As part of the Study of Women's Health Across the Nation, urinary luteinizing hormone (LH), follicle-stimulating hormone (FSH), estrogen conjugates (E1C), and pregnanediol glucuronide (PDG) were measured daily from a multiracial sample of 549 mid-life women for the duration of one menstrual cycle.

Diabetes and Uterine Fibroid Diagnosis in Midlife: Study of Women's Health Across the Nation (SWAN).

Context: Fibroids are noncancerous uterine tumors potentially associated with cardiovascular risk factors.

Objective: We aimed to examine prospectively associations of glucose, insulin, sex hormone-binding globulin (SHBG), and diabetes with incidence of fibroid diagnoses in midlife.

Methods: Participants in the Study of Women's Health Across the Nation (SWAN) cohort (n = 2570) reported fibroid diagnoses at enrollment (1996-1997) and 13 follow-up visits (1996-2013).

High-density lipoprotein metrics during midlife and future subclinical atherosclerosis in women: the SWAN HDL study.

Objective: The clinical utility of high-density lipoprotein cholesterol (HDL-C) in risk classification is limited, especially in midlife women. Novel metrics of HDL may better reflect this risk. We clustered a comprehensive profile of HDL metrics into favorable and unfavorable clusters and assessed how these two clusters are related to future subclinical atherosclerosis (carotid intima media thickness [cIMT], interadventitial diameter [IAD], and carotid plaque presence) in midlife women.

Hypertension, Cardiovascular Risk Factors, and Uterine Fibroid Diagnosis in Midlife.

Importance: Fibroids are benign neoplasms associated with severe gynecologic morbidity. There are no strategies to prevent fibroid development.

Objective: To examine associations of hypertension, antihypertensive treatment, anthropometry, and blood biomarkers with incidence of reported fibroid diagnosis in midlife.

Longitudinal Changes in Sex Hormone Binding Globulin (SHBG) and Risk of Incident Diabetes: The Study of Women's Health Across the Nation (SWAN).

Objective: To investigate the associations of longitudinal changes in sex hormone binding globulin (SHBG) and testosterone (T) over the menopause transition with the risk of diabetes.

Research Design And Methods: We followed 2,952 participants in the Study of Women's Health Across the Nation (SWAN) who were premenopausal or early perimenopausal and diabetes-free at baseline. SHBG,T, and estradiol (E2) levels were measured at up to 13 follow-up visits (over up to 17 years).

Trajectories of Sleep Over Midlife and Incident Cardiovascular Disease Events in the Study of Women's Health Across the Nation.

Background: Up to 50% of women report sleep problems in midlife, and cardiovascular disease (CVD) is the leading cause of death in women. How chronic poor sleep exposure over decades of midlife is related to CVD risk in women is poorly understood. We tested whether trajectories of insomnia symptoms or sleep duration over midlife were related to subsequent CVD events among SWAN (Study of Women's Health Across the Nation) participants, whose sleep was assessed up to 16 times over 22 years.

Carotid intima media thickness and cardiometabolic dysfunction: the Study of Women's Health Across the Nation.

Objective: Carotid artery intima media thickness (cIMT) and adventitial diameter (AD) are subclinical atherosclerosis indicators. Metabolic syndrome (MetS) and obesity are risk factors for atherosclerosis, but their combined impact on atherosclerosis risk is unknown. This study sought to examine the effect of the co-occurrence of MetS with obesity on cIMT and AD.

Low-density lipoprotein subclasses over the menopausal transition and risk of coronary calcification and carotid atherosclerosis: the SWAN Heart and HDL ancillary studies.

Objective: Perimenopausal women experience a steep increase in low-density lipoprotein cholesterol (LDL-C) that is related to a higher risk of carotid plaque later in life. Low-density lipoprotein subclasses have been linked to cardiovascular diseases beyond LDL-C, promising a better risk stratification. We aim to characterize changes in LDL subclasses and assess their associations with presence of coronary artery calcium (CAC score ≥10) and carotid intima-media thickness (cIMT) over the menopausal transition (MT) and by menopause stage.

Cardiovascular Disease in Women: Does Menopause Matter?

It is known that the menopause transition (MT) is a complex period during a woman's life, but there has been ongoing debate on whether the increase in cardiovascular disease (CVD) during midlife is due to chronological aging or ovarian aging. The purpose of this review is to summarize the recent findings on the role of ovarian aging versus chronological aging on cardiovascular disease (CVD) outcomes and its risk factors in women. Recent data from longitudinal studies have shown that menopause-related factors, such as earlier age at menopause and surgical menopause are associated with higher CVD outcomes.

The quantity and quality of cardiovascular fat at mid-life and future cognitive performance among women: The SWAN cardiovascular fat ancillary study.

Introduction: Cardiovascular fat is a novel risk factor that may link to dementia. Fat volume and radiodensity are measurements of fat quantity and quality, respectively. Importantly, high fat radiodensity could indicate healthy or adverse metabolic processes.

The menopause transition: a critical stage for cardiovascular disease risk acceleration in women.

The menopause transition is a critical period for cardiovascular health. During this stage, women experience adverse changes in multiple components that are key for optimal cardiovascular health. Additionally, women struggle to maintain ideal health behaviors, which if adopted collectively, have been shown in observational studies to prevent more than 70% of coronary heart disease cases.

JCL Roundtable: Lipidology and Women's Health.

In this JCL Roundtable, we bring together three experts to discuss women's cardiovascular health throughout the lifespan, viewed from the standpoint of clinical lipidology. Overall, heart disease leads to one out of every 3 deaths of American women, but unfortunately patient awareness of cardiovascular risk actually has declined since 2009. Younger women are not exempt, since their risk can be increased by smoking, birth control, adverse lifestyle and diet, and genetic disorders.

The independent associations of anti-Müllerian hormone and estradiol levels over the menopause transition with lipids/lipoproteins: The Study of Women's health Across the Nation.

Background: The menopause transition (MT) is linked to adverse changes in lipids/lipoproteins. However, the related contributions of anti-Müllerian hormone (AMH) and estradiol (E2) are not clear.

Objective: To evaluate the independent associations of premenopausal AMH and E2 levels and their changes with lipids/lipoproteins levels [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein B (apoB) and apolipoprotein A-1 (apoA-1)] over the MT.

Early Midlife Cardiovascular Health Influences Future HDL Metrics in Women: The SWAN HDL Study.

Background Utility of high-density lipoprotein cholesterol (HDL-C) in assessing the antiatherogenic properties of HDL may be limited in midlife women. Novel metrics of HDL function, lipid contents, and subclasses may better reflect the atheroprotective capacities of HDL, supporting the need to evaluate how cardiovascular health affects these metrics in women. We assessed the relationship of early midlife Life's Simple 7 (LS7) score and its health behavior components with future HDL function (HDL-cholesterol efflux capacity), HDL-phospholipid, HDL-triglyceride, HDL particles (HDL-P) and size, and the relationship between LS7 score and changes in HDL metrics over time.

Pre- and Early Peri-menopausal Physical Function and Risk of Cardiovascular Events: The Study of Women's Health Across the Nation.

Objectives: To determine whether physical function (PF) before menopause is related to cardiovascular disease (CVD) risk.

Methods: Participants were = 2950 pre-/early peri-menopausal women (median age 46, (25th-75th percentile: 43-48 years). Physical function was assessed at baseline using the Physical Function subscale of the SF-36 and scores were trichotomized (no, some, or substantial limitations).