Risk factors, angiographic findings, and menopausal status in women with chronic stable coronary heart disease

To assess the prevalence of risk factors and angiographic findings, we evaluated 321 women with chronic stable coronary heart disease, 108 premenopausal and 213 post-menopausal. The diagnosis for postmenopausal women was based on history of having spontaneously stopped menstruating for at least 12 months of natural menopause. The evidence of coronary heart disease was characterized by one or more of the following criteria: stable angina, transient ischemic stress test, old myocardial infarction, and coronary angiography showing >70% diameter obstruction of at least one major artery. Age, obesity, previous myocardial infarction, current cigarette smoking, hypertension, diabetes, plasma lipid profile, and number of major coronary vessels involved were evaluated. Hypertension was the most prevalent risk factor for both groups (67.6 vs. 69.5%; p = NS). Premenopausal women had higher prevalence of cigarette smoking (p < 0.0001), insulin-dependent diabetes mellitus (p = 0.04), and left ventricular dysfunction (p = 0.003). Postmenopausal women had a higher body mass index (p = 0.01). There was no statistical difference between groups in terms of previous myocardial infarction, plasma lipid profile, and extent of coronary artery disease. These data suggest that hypertension, smoking, and diabetes were the most prevalent risk factors for coronary heart disease in premenopausal women and hypertension and overweight in postmenopausal women.