Exploring the relationship between reproductive aging, arterial stiffness, and cardiorespiratory fitness in women after menopause

Abstract

This cross-sectional study examined associations between postmenopausal stage (early and late), arterial stiffness, and cardiorespiratory fitness. A total of 125 postmenopausal women (58.07 ± 6.61 years) underwent carotid-femoral pulse wave velocity assessment (SphygmoCor, Atcor). A subset of 96 women (57.20 ± 6.42 years) completed an estimated maximal oxygen uptake testing, using a Monark Ergomedic 839E cycle ergometer. Multiple stepwise regressions identified predictors of arterial stiffness and cardiorespiratory fitness. Compared with late postmenopause, early postmenopausal women showed lower arterial stiffness (−0.71 ± 0.29 m/s, p = 0.02) and systolic blood pressure (−6.40 ± 3.06 mmHg, p = 0.04), indicating a relative difference within postmenopause. Early postmenopause also showed higher cardiorespiratory fitness levels than late postmenopause. Moreover, body fat percentage was inversely associated with cardiorespiratory fitness in +1c substage, and visceral fat level displayed inverse associations with cardiorespiratory fitness in late postmenopause. In the +1a substage, hormone therapy was positively associated with cardiorespiratory fitness in exploratory model. Within postmenopause, early postmenopause showed lower arterial stiffness and systolic blood pressure than late postmenopause, and blood pressure and adiposity emerged as key correlates of vascular stiffness and fitness. While causal inference is precluded by the cross-sectional design, the results support stage-targeted strategies emphasizing BP control, body-composition management, and exercise to help preserve vascular and functional health in women after menopause.