Reproductive Hormones And Pre-Clinical Cardiovascular Disease (CVD) In Women

Heart disease is not just the number one killer of women, it is also a leading cause of
disability. While it is generally believed that heart disease in women is a disease of old
age, the stark reality is that heart disease is responsible for more deaths than breast
cancer AT ALL AGES. Also, when young women develop heart disease, they are more likely to die
or become disabled than their male peers. Identifying women at risk for heart disease is an
important step toward reducing the impact of this disease.

Although women can develop heart disease at any age, most women show signs and symptoms of
disease about 10 years after men. For years, it has been thought that the reason for this lag
is that women's hearts are protected by estrogen, and that when women go through menopause
and lose their natural estrogen, they also lose their protection from heart disease. It has
been assumed that if estrogen is replaced then protection will continue. These assumptions
have not been proven. In fact, three large, randomized trials have shown no benefit from
hormone replacement therapy in women known to have heart disease, and in fact have shown that
hormone replacement may be harmful.

To better understand the role of hormones and heart disease, the investigators propose to
look at markers of heart disease in healthy women and compare this to their natural hormone
levels. One of the markers known to be related to heart disease is carotid artery
intima-medial thickness (c-IMT) which can be measured by creating an ultrasound picture of an
artery in the neck. The investgators will use c-IMT scans and serum blood samples from women
in the NIH-sponsored Los Angeles Atherosclerosis Study (LAAS), a large epidemiologic study
that followed participants for 8 years. The proposed study will use risk factor information,
serum samples and c-IMT scans collected from the female participants (about 269 women) over
the 8 years of follow-up. The total sample size is 269 subjects, each of whom donated 3 blood
specimens for the LAAS study. This research will examine those specimens (800 in total). It
will also measure other markers of heart disease, including inflammation (hsCRP) and diabetes
(insulin and glucose). All information has been obtained and there will be no need to collect
additional information from participants nor additional blood specimens.