Age at Natural Menopause Impacts Cerebrovascular Reactivity and Brain Structure

Am J Physiol Regul Integr Comp Physiol. 2023 Jan 9. doi: 10.1152/ajpregu.00228.2022. Online ahead of print.ABSTRACTMenopause is associated with adverse changes in vascular health coinciding with an increased risk of stroke and vascular cognitive impairment. However, there is significant variation in the age at menopause. The present study examined how the age at natural menopause impacts cerebrovascular reactivity and structural biomarkers of brain aging. Thirty-five healthy postmenopausal women were classified as early onset menopause (Early; n = 19, age at menopause: 47 ± 2 years) or later onset menopause (Late; n = 16, age at menopause: 55 ± 2 years). Middle cerebral artery blood velocity (MCAv), mean arterial blood pressure (MAP), and end-tidal carbon dioxide (ETCO₂) were recorded during a stepped hypercapnia protocol. Reactivity was calculated as the slope of the relationship between ETCO₂ and each variable of interest. Brain volumes and white matter hyperintensities (WMH) were obtained with 3T MRI. Resting MAP was greater in the Early group (99 ± 9 mmHg) compared with the Late group (90 ± 12 mmHg; P = 0.02). Cerebrovascular reactivity, assessed using MCAv, was blunted in the Early group (1.87 ± 0.92 cm/s/mmHg) compared to the Late group (2.37 ± 0.75 cm/s/mmHg; P = 0.02). Total brain volume did not differ between groups (Early: 1.08 ± 0.07L vs. Late: 1.07 ± 0.06L; P = 0.66), but the Early group demonstrated greater WMH fraction compared with the Late group (E...
Source: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology - Category: Physiology Authors: Source Type: research