Oxidative Stress and Menopausal Status: The Coronary Artery Risk Development in Young Adults Cohort Study

Amir S. Heravi, Erin D. Michos, Di Zhao, Bharath Ambale-Venkatesh, Henrique Doria De Vasconcellos, Donald Lloyd-Jones, Pamela J. Schreiner, Jared P. Reis, Colin Wu, Cora E. Lewis, James M. Shikany, Stephen Sidney, Eliseo Guallar, Chiadi E. Ndumele, Pamela Ouyang, Ron C. Hoogeveen, Joao A.C. Lima, Dhananjay Vaidya, Wendy S. Post

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Low endogenous estrogen concentrations after menopause may contribute to higher oxidative stress and greater cardiovascular disease (CVD) risk. However, differences in oxidative stress between similarly aged premenopausal and postmenopausal women are not well-characterized on a population level. We hypothesized that urinary isoprostane concentrations, a standard measure of systemic oxidative stress, are higher in women who have undergone menopause compared to premenopausal women. Methods and Results: We examined differences in urinary 8-isoprostane (iPF2α-III) and 2,3-dinor-8-isoprostane (iPF2α-III-M) indexed to urinary creatinine between 279 postmenopausal and 196 premenopausal women in the Coronary Artery Risk Development in Young Adults (CARDIA) study, using linear regression with progressive adjustment for sociodemographic factors and traditional CVD risk factors. Unadjusted iPF2α-III-M concentrations were higher among postmenopausal compared to premenopausal women (Median [25th, 75th percentile]: 1762 [1178, 2974] vs. 1535 [1067, 2462] ng/g creatinine; p = 0.01). Menopause was associated with 25.5% higher iPF2α-III-M (95% confidence interval [6.5-47.9]) adjusted for age, race, college education, and field center. Further adjustments for tobacco use (21.2% [2.9-42.6]) and then CVD risk factors (18.8% [0.1-39.6]) led to additional partial attenuation. Menopause was associated with higher iPF2α-III in Black but not White women. Conclusions: We conclude that postmenopausal women had higher oxidative stress, which may contribute to greater CVD risk. ClinicalTrials.gov Identifier: NCT00005130.

Original languageEnglish (US)
Pages (from-to)1057-1065
Number of pages9
JournalJournal of Women's Health
Issue number7
StatePublished - Jul 1 2022

Bibliographical note

Funding Information:
This work was funded by the American Heart Association Go Red for Women Strategically Focused Research Network grant 16SFRN27870000. A.S.H. was awarded funding provided, in part, by Nancy Grasmick, EdD, the Division of Cardiology, Department of Medicine and the Office of Medical Student Affairs of Johns Hopkins School of Medicine to conduct 1 year of dedicated research as a medical student. E.D.M. and D.Z. are additionally funded by the Blumenthal Scholars Award in Preventive Cardiology at Johns Hopkins University. The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I from the National Heart, Lung, and Blood Institute (NHLBI). Funding sources were not involved in study design, analysis, interpretation of data, or the writing of the report.

Funding Information:
The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), North-western University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). This article has been reviewed by CARDIA for scientific content.

Publisher Copyright:
© Copyright 2022, Mary Ann Liebert, Inc., publishers 2022.


  • cardiovascular risk factors
  • isoprostanes
  • menopause
  • oxidative stress
  • urinary isoprostanes


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