THE PREVALENCE OF METABOLIC DISORDERS AND HYPERTENSION IN WOMEN DURING PERIMENOPAUSE AND MENOPAUSE
Abstract
Introduction/Objective: Cardiometabolic diseases, including type 2 diabetes (T2D) and cardiovascular disease, and their associated factors, such as hypertension, dyslipidemia, insulin resistance, and obesity, are among the leading causes of morbidity and mortality. At a young age, the prevalence of cardiometabolic diseases is higher in men than in women, but this female advantage gradually disappears with aging, particularly after menopause, when cardiometabolic risk factors accumulate.
Our research aimed to highlight the prevalence of metabolic disorders and their association with hypertension in women during perimenopause and menopause.
Method: The study included 200 middle-aged women: 131 (65.5%) perimenopausal women who had experienced typical perimenopausal signs for more than 6 months, and 69 (34.5%) menopausal women with absent menstrual cycles for more than 12 months, aged 50-59 years. The patients visited their physician for a routine preventive examination in December 2024.
Results: Hypertension was statistically significantly more common in women in menopause (84.1%) compared to premenopausal women (p < 0.001). Women in menopause had significantly higher rates of metabolic disorders, increased body mass and obesity, with 66.7% of the participants affected, as well as a larger waist circumference in 63.8% of the participants (p = 0.003). Menopausal women had statistically significantly higher levels of triglycerides, LDL cholesterol, and total cholesterol than premenopausal women (p = 0.002). Among women going through menopause, diabetes mellitus was statistically substantially more prevalent, affecting 27% of them (p = 0.002). Premenopausal women had a statistically significantly greater prevalence of hypothyroidism (14.7%) than did menopausal women (4.3%) (chi-square = 4.905, p = 0.027). These two groups of participants did not differ significantly in terms of sedentary habits, smoking, or family history of hypertension.
Conclusion: Type 2 diabetes, obesity, dyslipidaemia, and hypertension were all substantially more common in menopausal women. Preventive screenings are therefore crucial for women going through menopause and perimenopause to promptly detect and treat cardiometabolic disorders and prevent more serious cardiovascular diseases.
References
Rehman A, Lathief S, Charoenngam N, Pal L. Aging and Adiposity—Focus on Biological Females at Midlife and Beyond. Int J Mol Sci. 2024 Mar 4;25(5):2972. doi: 10.3390/ijms25052972.
Shifren JL, Gass ML; NAMS Recommendations for Clinical Care of Midlife Women Working Group. The North American Menopause Society recommendations for clinical care of midlife women. Menopause. 2014 Oct;21(10):1038-62. doi: 10.1097/GME.0000000000000319.
Elder P, Sharma G, Gulati M, Michos ED. Identification of female-specific risk enhancers throughout the lifespan of women to improve cardiovascular disease prevention. Am J Prev Cardiol. 2020 Jun 6;2:100028. doi: 10.1016/j.ajpc.2020.100028.
Peters SA, Huxley RR, Woodward M. Diabetes as risk factor for incident coronary heart disease in women compared with men: a systematic review and meta-analysis of 64 cohorts including 858,507 individuals and 28,203 coronary events. Diabetologia. 2014 Aug;57(8):1542-51. doi: 10.1007/s00125-014-3260-6.
Nguyen AH, Hurwitz M, Sullivan SA, Saad A, Kennedy JLW, Sharma G. Update on sex specific risk factors in cardiovascular disease. Front Cardiovasc Med. 2024 Feb 6;11:1352675. doi: 10.3389/fcvm.2024.1352675.
Huxley RR, Woodward M. Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studies. Lancet. 2011 Oct 8;378(9799):1297-305. doi: 10.1016/S0140-6736(11)60781-2.
Anand SS, Islam S, Rosengren A, Franzosi MG, Steyn K, Yusufali AH, et al.; INTERHEART Investigators. Risk factors for myocardial infarction in women and men: insights from the INTERHEART study. Eur Heart J. 2008 Apr;29(7):932-40. doi: 10.1093/eurheartj/ehn018.
Hemal K, Pagidipati NJ, Coles A, Dolor RJ, Mark DB, Pellikka PA, et al. Sex Differences in Demographics, Risk Factors, Presentation, and Noninvasive Testing in Stable Outpatients With Suspected Coronary Artery Disease: Insights From the PROMISE Trial. JACC Cardiovasc Imaging. 2016 Apr;9(4):337-46. doi: 10.1016/j.jcmg.2016.02.001.
Kalyani RR, Lazo M, Ouyang P, Turkbey E, Chevalier K, Brancati F, et al. Sex differences in diabetes and risk of incident coronary artery disease in healthy young and middle-aged adults. Diabetes Care. 2014;37(3):830-8. doi: 10.2337/dc13-1755.
Smiljić S, Ilić A. The impact of dyslipidemia and hyperhomocysteinemia on the development of arterial hypertension. Galenika Medical Journal. 2024;3(9):7-13. doi: 10.5937/Galmed2409007S.
Joyner JM, Hutley LJ, Cameron DP. Estrogen receptors in human preadipocytes. Endocrine. 2001 Jul;15(2):225-30. doi: 10.1385/ENDO:15:2:225.
Mou H, Zhang J, Guo Y, Xu L, Luo X. Effects of key physiological parameters on cardiovascular disease and osteoporosis risk in perimenopausal and postmenopausal women. Sci Rep. 2025 Jan 22;15(1):2814. doi: 10.1038/s41598-025-86613-8. Erratum in: Sci Rep. 2025 Mar 25;15(1):10251. doi: 10.1038/s41598-025-95430-y.
Nie G, Yang X, Wang Y, Liang W, Li X, Luo Q, et al. The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis. Front Pharmacol. 2022 Apr 12;13:850815. doi: 10.3389/fphar.2022.850815.
Mahabadi AA, Massaro JM, Rosito GA, Levy D, Murabito JM, Wolf PA, et al. Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study. Eur Heart J. 2009 Apr;30(7):850-6. doi: 10.1093/eurheartj/ehn573.
Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al.; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004 Sep 11-17;364(9438):937-52. doi: 10.1016/S0140-6736(04)17018-9.
Kostis WJ, Cheng JQ, Dobrzynski JM, Cabrera J, Kostis JB. Meta-analysis of statin effects in women versus men. J Am Coll Cardiol. 2012 Feb 7;59(6):572-82. doi: 10.1016/j.jacc.2011.09.067. Erratum in: J Am Coll Cardiol. 2012 Apr 17;59(16):1491.
Lu W, Resnick HE, Jablonski KA, Jones KL, Jain AK, Howard WJ, et al. Non-HDL cholesterol as a predictor of cardiovascular disease in type 2 diabetes: the strong heart study. Diabetes Care. 2003 Jan;26(1):16-23. doi: 10.2337/diacare.26.1.16.
Welsh A, Hammad M, Piña IL, Kulinski J. Obesity and cardiovascular health. Eur J Prev Cardiol. 2024 Jun 3;31(8):1026-35. doi: 10.1093/eurjpc/zwae025.
Nilsson S, Qvick A, Henriksson M, Lawesson SS, Holm AS, Leander K. Menopausal Vasomotor Symptoms and Subclinical Atherosclerotic Cardiovascular Disease: A Population-Based Study. J Am Heart Assoc. 2024 Sep 3;13(17):e033648. doi: 10.1161/JAHA.123.033648.
Marchi R, Dell'Agnolo CM, Lopes TCR, Gravena AAF, Demitto MO, Brischiliari SCR, et al. Prevalence of metabolic syndrome in pre- and postmenopausal women. Arch Endocrinol Metab. 2017 Mar-Apr;61(2):160-6. doi: 10.1590/2359-3997000000253.
Wyne KL, Nair L, Schneiderman CP, Pinsky B, Antunez Flores O, Guo D, et al. Hypothyroidism Prevalence in the United States: A Retrospective Study Combining National Health and Nutrition Examination Survey and Claims Data, 2009-2019. J Endocr Soc. 2022 Nov 10;7(1):bvac172. doi: 10.1210/jendso/bvac172.
Vargas-Uricoechea H, Castellanos-Pinedo A, Urrego-Noguera K, Pinzón-Fernández MV, Meza-Cabrera IA, Vargas-Sierra H. A Scoping Review on the Prevalence of Hashimoto's Thyroiditis and the Possible Associated Factors. Med Sci (Basel). 2025 Apr 10;13(2):43. doi: 10.3390/medsci13020043.
Pant A, Chew DP, Mamas MA, Zaman S. Cardiovascular Disease and the Mediterranean Diet: Insights into Sex-Specific Responses. Nutrients. 2024 Feb 19;16(4):570. doi: 10.3390/nu16040570.
