Assessment of cardiovascular risk in post-menopausal women in Ghana

Background : Cardiovascular diseases (CVD) continue to be a major cause of death among post-menopausal women. We sought to assess cardiovascular risk among pre- and post-menopausal women living within the Cape Coast Municipality by comparing the lipid profiles and other emerging biomarkers of CVD, i.e. the atherogenic index of plasma (AIP), visceral adiposity index (VAI), body adiposity index (BAI) and Castelli index I (CRI-I). Methods: A comparative cross-section of 150 women (75 pre-menopausal women and 75 post-menopausal women) visiting the University of Cape Coast hospital for regular checkups were randomly recruited into the study. Socio-demographic and clinical characteristics of participants were obtained with the aid of a structured questionnaire. Blood pressure (BP) was measured and lipid profile was estimated using fasting blood samples. Other markers of cardiovascular risk such as BMI, AIP, VAI, BAI and CRI-I were estimated. Results: We report elevated levels of total cholesterol (TC) (p<0.0001), low density lipoprotein (LDL) (p<0.0001), very low-density lipoprotein (VLDL) (p=0.0021), triglycerides (TG) (p<0.0001) and non-high-density lipoprotein (non-HDL-C) cholesterol (p<0.0001) in post-menopausal women compared with pre-menopausal women. High-density lipoprotein (HDL) (p<0.0001) was, however, decreased in post-menopausal women. Mean AIP (p< 0.0001), VAI (p< 0.0001), BAI (p< 0.0038) and CRI-I (p<0.0001) were significantly increased in post-menopausal women compared to pre-menopausal women. We also report a positive correlation of TC, TG, VLDL and non-HDL with atherogenic markers AIP, VAI and CRI-I in post-menopausal women. A negative correlation of HDL with AIP, VAI, and CR in post-menopausal women was also observed. Conclusions: Menopause could lead to changes in lipid profile to atherogenicity with associated increase in the risk of CVD. Atherogenic markers such as AIP, VAI, BAI, and CR can serve as potential biomarkers for predicting CVD.