Characterizing vascular and hormonal changes in women across the life span: a cross-sectional analysis
| Author(s) | Wenner, Megan M. | |
| Author(s) | Shenouda, Ninette | |
| Author(s) | Shoemaker, Leena | |
| Author(s) | Kuczmarski, Andrew | |
| Author(s) | Haigh, Katherine | |
| Author(s) | Del Vecchio, Angelica | |
| Author(s) | Schwab, Allyson | |
| Author(s) | McGinty, Shane J. | |
| Author(s) | Edwards, David G. | |
| Author(s) | Pohlig, Ryan T. | |
| Author(s) | Nuckols, Virginia R. | |
| Author(s) | DuBose, Lyndsey | |
| Author(s) | Moreau, Kerrie L. | |
| Date Accessioned | 2025-01-07T18:18:15Z | |
| Date Available | 2025-01-07T18:18:15Z | |
| Publication Date | 2024-11-01 | |
| Description | This article was originally published in American Journal of Physiology - Heart and Circulatory Physiology. The version of record is available at: https://doi.org/10.1152/ajpheart.00373.2024. Copyright © 2024 the American Physiological Society. This article will be embargoed until 11/01/2025. This research was featured in UDaily on 5/12/2025 at: https://www.udel.edu/udaily/2025/may/womens-health-month-megan-wenner-hormone-research/ | |
| Abstract | Vascular dysfunction, marked by lower endothelial function and increased aortic stiffness, is a nontraditional risk factor that precedes the development of cardiovascular disease (CVD). However, the age at which these changes in vascular function occur in women and the degree to which reproductive hormones mediate these changes has not been characterized. Women free from major disease were enrolled across the adult life span (aged 18–70 yr, n = 140). Endothelial function was assessed as flow-mediated dilation (FMD) of the brachial artery during reactive hyperemia using duplex ultrasound and expressed as percent dilation. Aortic stiffness was measured by carotid-femoral pulse wave velocity (cfPWV). Blood samples were obtained to quantify reproductive hormone concentration. Regression models determined age-related breakpoints and mediating factors between age and vascular outcomes. FMD declined with age with a breakpoint and steeper decline occurring at 47 yr of age. Thereafter, age was independently associated with lower FMD (B = −0.13, P < 0.001). cfPWV was relatively stable until a breakpoint at age 48, and age was independently associated with higher cfPWV thereafter (B = 0.10, P < 0.001). Path analysis revealed that the association between age and FMD was partially mediated by follicle-stimulating hormone (abind = 0.051, P = 0.01) and progesterone (abind = 0.513, P < 0.001) but not estradiol (abind = −0.004, P = 0.08). No mediation was present for cfPWV. Age was associated with endothelial dysfunction and aortic stiffness in women beginning at 47 and 48 yr old, respectively, 3 to 4 yr before the average age of menopause. The association between age and endothelial dysfunction was explained in part by elevations in follicle-stimulating hormone and progesterone, but not declining estradiol. NEW & NOTEWORTHY We demonstrate that the age at which endothelial function declines and aortic stiffness increases in healthy women is 47 and 48, respectively. The inflection point in flow-mediated dilation (FMD) is 6 yr earlier than previously reported, and the association between age and FMD was mediated by follicle-stimulating hormone (FSH) and progesterone (P4) but not estradiol (E2). Graphical abstract available at: https://doi.org/10.1152/ajpheart.00373.2024 | |
| Sponsor | This research was supported by National Institutes of Health Grants R01-HL146558 (to M.M.W.), P20-GM113125 (to D.G.E.) via the Center of Biomedical Research Excellence in Cardiovascular Health, and U54-AG062319 (to K.L.M.). | |
| Citation | Wenner, Megan M., Ninette Shenouda, Leena Shoemaker, Andrew Kuczmarski, Katherine Haigh, Angelica Del Vecchio, Allyson Schwab, et al. “Characterizing Vascular and Hormonal Changes in Women across the Life Span: A Cross-Sectional Analysis.” American Journal of Physiology-Heart and Circulatory Physiology 327, no. 5 (November 1, 2024): H1286–95. https://doi.org/10.1152/ajpheart.00373.2024. | |
| ISSN | 1522-1539 | |
| URL | https://udspace.udel.edu/handle/19716/35695 | |
| Language | en_US | |
| Publisher | American Journal of Physiology - Heart and Circulatory Physiology | |
| Keywords | aging | |
| Keywords | arterial stiffness | |
| Keywords | endothelial function | |
| Keywords | estrogen | |
| Keywords | sex hormones | |
| Title | Characterizing vascular and hormonal changes in women across the life span: a cross-sectional analysis | |
| Type | Article |
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