White Matter Hyperintensity Burden Up for Postmenopausal Women

WEDNESDAY, July 6, 2022 — Postmenopausal women appear to have a higher burden of white matter hyperintensity (WMH) than similar-aged men and women who are premenopausal, according to a study published online June 29 in Neurology.

Valerie Lohner, from the German Center for Neurodegenerative Diseases in Bonn, and colleagues examined the sex differences and age dependencies in WMH load across the adult life span in a cross-sectional analysis involving participants of the population-based Rhineland Study (aged 30 to 95 years) who underwent brain magnetic resonance imaging. WMH was quantified using T1-weighted, T2-weighted, and FLAIR images. Of the 3,410 participants, 1,973 (57.9 percent) were women, of whom 1,167 (59.1 percent) were postmenopausal.

The researchers found that the increase in WMH load accelerates with age in a sex-dependent manner. No difference was seen in WMH burden for premenopausal women and men of similar age. However, compared with men of similar age, WMH burden was higher and accelerated faster among postmenopausal women. There were changes related to menopause, with higher WMH for postmenopausal women than premenopausal women of similar age. A higher WMH burden was seen for women with uncontrolled hypertension compared with men, which was not related to menopause status.

The results of our study “demonstrate the necessity to account for different health trajectories for men and women, and menopausal status,” a coauthor said in a statement. “Our research underscores the importance of sex-specific medicine and more attentive therapy for older women, especially those with vascular risk factors.”

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