Severity of menopausal symptoms and cardiovascular and osteoporosis risk factors

ABSTRACT

Objectives To assess whether the severity of menopausal symptoms is related to increased cardiovascular and osteoporosis risk factors, and to determine whether women with more severe menopausal symptoms present a greater percentage of osteoporosis disease.

Methods This was a cross-sectional, descriptive study encompassing women aged 45–65 years in the whole Spanish territory. The study population sample was collected through random sampling. A total of 10 514 women were included. Their sociodemographic, medical history and lifestyle data were assessed by means of a survey. The Kupperman Index was used to assess the severity of menopausal symptoms. Bone mineral density was measured by the dual X-ray absorptiometry method.

Results The prevalences of risk factors for osteoporosis and cardiovascular disease were 67.6% and 74.8%, respectively. Women with a higher intensity of symptoms also had a greater percentage of cardiovascular (p < 0.001) and osteoporosis (p < 0.001) risk factors and suffered more from osteoporosis disease (p < 0.001). In the logistic regression analysis, those variables that contributed to the severity of menopausal symptoms were: arterial hypertension (odds ratio (OR) 2.14; 95% confidence interval (CI) 1.49–2.79; p < 0.001), dyslipidemia (OR 1.94; 95% CI 1.48–2.4; p < 0.001), obesity (OR 2.23; 95% CI 1.55–2.91; p < 0.001), family history (OR 1.38; 95% CI 1.17–1.59; p < 0.01), medication use (OR 1.12; 95% CI 0.52–1.72; p < 0.01) and osteoporosis disease (OR 3.71; 95% CI 2.9–4.52; p < 0.001).

Conclusions Women with more severe menopausal symptoms had a greater prevalence of cardiovascular and osteoporosis disease risk factors and suffered more from osteoporosis disease compared to those who had milder or no menopausal symptoms.

Key words::

• SEVERITY OF MENOPAUSAL SYMPTOMS
• CARDIOVASCULAR RISK FACTORS
• RISK FACTORS FOR OSTEOPOROSIS
• OSTEOPOROSIS DISEASE

ACKNOWLEDGEMENTS

The authors wish to express their sincere gratitude to all investigators who have actively participated in this study. Without their dedication and quality of work, this publication would not have been possible. Unfortunately, the list of investigators is too long to include in this manuscript. We would also like to thank Almirall Pharmaceuticals and Sanofi-Aventis for their support, which was indispensable in order to complete this observational study.

Conflict of interest The authors report no conflict of interest. The authors alone are responsible for the content and writing of this paper.

Source of funding Funding was provided by Almirall Pharmaceuticals and Sanofi-Aventis.

Appendix: Questionnaire

Sociodemographic factors

1. Patient initials:

2. Date of birth, day/month/year:

3. Marital status: Unmarried; Married; Divorced or separated; Widowed

4. Living environment: Rural; Urban

5. Educational level: Lower than primary education; Primary education; Secondary education; University education

6. Employment situation: Active; Housewife; Pensioner; Unemployed

7. Profession:

8. Are you the highest earner in your home? Yes; No

9. Profession of the highest earner in your home:

10. Employment situation of the highest earner in your home: Active; Housewife; Pensioner; Unemployed

Medical history

11. Family history: Osteoporotic fractures in first-degree relative; History of breast cancer in first-degree relative; History of uterine cancer in first-degree relative; History of cardiovascular pathology in first-degree relative

12. Gynecological history: Menarche (age); Menopause (age); Type of menopause: natural, surgical, iatrogenic; Number of children; Menstrual cycle: regular, irregular

13. Menopausal symptoms: Hot flushes, sweating – Intensity 0 1 2 3; Paresthesia – Intensity 0 1 2 3; Insomnia/sleep disturbances – Intensity 0 1 2 3; Irritability/nervousness – Intensity 0 1 2 3; Depressive mood/melancholy – Intensity 0 1 2 3; Dizziness/fainting – Intensity 0 1 2 3; Tiredness/weakness – Intensity 0 1 2 3; Arthralgias/myalgias – Intensity 0 1 2 3; Cephalea – Intensity 0 1 2 3; Palpitations – Intensity 0 1 2 3; Tingling – Intensity 0 1 2 3

14. Personal history of osteoporosis: No; Yes – History of osteoporotic fracture from 35 years: No Yes; BMD test: T-score:

15. Medication related to risk of osteoporosis and fracture: Anticonvulsants; Thyroid hormones; Oral and inhaled glucocorticoids; Oral hypoglucemiants; Oral/heparin anticoagulants; Benzodiazepines; Antiarrhythmics; Insulins; Lithium

16. Diseases that affect bone metabolism and increase the risk of falling: Chronic hepatopathy; Cushing's syndrome; Hyperparathyroidism; Cerebrovascular accident; Malabsorption; Hyperthyroidism; Type I diabetes mellitus; Secondary amenorrhea lasting over 1 year; COPD; Rheumatoid arthritis; Urolithiasis; Parkinson's disease; Gastrectomy

17. Physical data: Size; Weight; Body mass index; Blood pressure; Blood glucose; Lipid levels

Lifestyle factors

18. Smoking status: Non-smoker; Smoker: 1–10; 11–20; > 20

19. Alcohol intake: No alcohol; Drinkers: Moderate (1–5 drinks per day); Heavy (> 6 drinks per day)

20. Consumption of dairy products: Normal; Poor dairy products

21. Exercise: No exercise; Moderate; Weight-bearing