From the IRCCS "S. Lucia," Rome (M.M., E.T., C.C.), and
Clinic of Neurology, "Tor Vergata" University of Rome (B.C.M.,
C.C., M.S.) (Italy).
Correspondence to Dr Mauro Silvestrini, Clinica Neurologica, Universita' di Roma "Tor Vergata," Ospedale S. Eugenio, P. le dell'Umanesimo 10, 00144 Rome, Italy.
Background and
Purpose—Hemodynamic factors seem to play an
important role in the pathogenesis of cerebral ischemic events.
The aim of this study was to evaluate whether changes in
cerebrovascular reactivity occur in women after menopause.
Methods—Using transcranial Doppler
ultrasonography, we studied the changes of flow velocity after
hypercapnia in the middle cerebral arteries of 45 healthy premenopausal
women (mean age, 32.3 years; range, 20 to 47 years) and 40
postmenopausal women (mean age, 54.4 years; range, 48 to 64 years). The
same measurements were recorded in two groups of healthy male
subjects age matched with premenopausal (45 subjects) and
postmenopausal women (40 subjects). Moreover, a subgroup of
postmenopausal women aged 48 to 53 years (15 subjects) were compared
with a group of 15 premenopausal women of the same age. We obtained
hypercapnia with breath holding and evaluated cerebrovascular
reactivity with the breath-holding index (BHI).
Results—BHI was significantly lower in postmenopausal women
(0.89±0.3) than in premenopausal women (1.59±0.3;
P<0.0001) and in young (1.34±0.5;
P<0.001) and old men (1.20±0.4;
P<0.04). In the latter group, BHI was significantly
lower than in premenopausal women (P<.0001). BHI values
were also significantly lower in postmenopausal than in premenopausal
women of the same age (0.81±0.1 versus 1.34±0.1;
P<0.0001).
Conclusions—These findings suggest that the large reduction of
cerebrovascular reactivity in postmenopausal women cannot be considered
a simple factor related to aging but is probably influenced by hormonal
changes. The alteration in cerebrovascular regulation could be involved
in the increase of cerebrovascular disease in postmenopausal women.
© 1998 American Heart Association, Inc.
Original Contributions
Age and Sex Differences in Cerebral Hemodynamics
A Transcranial Doppler Study
Key Words: gender • ultrasonography, Doppler, transcranial • vasomotor reactivity
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