Table of Contents
Advances in Vascular Medicine
Volume 2014, Article ID 204390, 12 pages
Review Article

Vascular Aging across the Menopause Transition in Healthy Women

Division of Geriatric Medicine, University of Colorado Denver, Building L15 Rm 8111, 12631 East 17th Avenue, P.O. Box 6511, Aurora, CO 80045, USA

Received 3 February 2014; Accepted 23 June 2014; Published 17 July 2014

Academic Editor: Shane A. Phillips

Copyright © 2014 Kerrie L. Moreau and Kerry L. Hildreth. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Vascular aging, featuring endothelial dysfunction and large artery stiffening, is a major risk factor for developing cardiovascular disease (CVD). In women, vascular aging appears to be accelerated during the menopause transition, particularly around the late perimenopausal period, presumably related to declines in ovarian function and estrogen levels. The mechanisms underlying endothelial dysfunction and large artery stiffening with the menopause transition are not completely understood. Oxidative stress and the proinflammatory cytokine tumor necrosis factor-α contribute to endothelial dysfunction and large artery stiffening in estrogen-deficient postmenopausal women. Habitual endurance exercise attenuates the age-related increase in large artery stiffness in estrogen-deficient postmenopausal women and can reverse arterial stiffening to premenopausal levels in estrogen-replete postmenopausal women. In contrast, estrogen status appears to play a key permissive role in the adaptive response of the endothelium to habitual endurance exercise in that endothelial improvements are absent in estrogen-deficient women but present in estrogen-replete women. We review here the current state of knowledge on the biological defects underlying vascular aging across the menopause transition, with particular focus on potential mechanisms, the role of habitual exercise in preserving vascular health, and key areas for future research.