Karen A Matthews's research while affiliated with University of Pittsburgh and other places

Publications (851)

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Objective: Vasomotor symptoms (VMS), the most frequently reported symptoms during the menopausal transition, have been associated with inflammation. Whether inflammation is a risk factor for or a consequence of VMS remains unclear. The objectives of these analyses were to determine if elevated proinflammatory marker levels were associated with inc...
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Objective: During midlife, women experience changes in lipoprotein profiles and deterioration in vascular health measures. We analyzed the associations of groups of lipoprotein subfractions as determined by principal component analysis (PCA) with subclinical vascular health measures in midlife women and tested if these associations were modified b...
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Objective: Ambulatory blood pressure monitoring (ABPM) increases restlessness during adults' sleep in laboratory settings, but there is little evidence of an association among adolescents or in naturalistic environments. This study examined activity levels before and after BP cuff inflation during sleep to determine whether, and for how long, ABPM...
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Background Traumatic experiences have been linked to risk for cardiovascular disease (CVD). Interpersonal violence is a trauma that is prevalent in women. Among midlife women followed up for 2 decades, we examined whether interpersonal violence (childhood abuse, adulthood abuse, or intimate partner violence [IPV]) was related to increased risk of s...
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Context The menopause transition is accompanied by declines in the atheroprotective features of high-density lipoprotein(HDL), which are linked to deleterious cardiovascular (CV) outcomes. Objective To assess the relationship between abdominal and cardiovascular (CV) visceral adipose tissues(AT) with future HDL metrics in midlife women, and the ro...
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Objectives: Increase in LDL-C occurs within 1 year of the final menstrual period (FMP), and this increase has been linked to a greater plaque risk. LDL subclasses have been linked to CAD beyond LDL-C, promising a better risk stratification. We aim to characterize changes in LDL subclasses over the menopause transition (MT) and assess associations o...
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Background Childhood socioeconomic disadvantage is associated with increased risk for chronic inflammation and cardiometabolic disease at midlife. Purpose As it is presently unknown whether inflammation mediates the relationship between childhood socioeconomic status (SES) and adulthood cardiometabolic risk, we investigated associations between re...
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Background Prevention of cardiovascular disease (CVD) is a public health priority. The combination of physical activity, a healthy diet, and abstaining from tobacco plays an important role in prevention whereas aspects of psychosocial well‐being have largely been examined separately with conflicting results. This study evaluated whether the combina...
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Study Objectives Polysomnography (PSG) is considered the “gold standard” for assessing sleep, but cost and burden limit its use. Although wrist actigraphy and self-report diaries are feasible alternatives to PSG, few studies have compared all three modalities concurrently across multiple nights in the home to assess their relative validity across m...
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Background: Depression is associated with inflammation, but the mechanisms underlying this association are unclear. We examined adiposity and smoking as potential pathways through which childhood depression may lead to an elevated inflammatory status among young adults. Methods: The sample included 294 subjects with histories of depression (prob...
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Objective: Sleep changes over the human lifespan, and it does so across multiple dimensions. We used individual-level cross-sectional data to characterize age trends and sex differences in actigraphy and self-report sleep dimensions across the healthy human lifespan. Methods: The Pittsburgh Lifespan Sleep Databank (PLSD) consists of harmonized p...
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Background: Whether changes in blood pressure (BP) over women's midlife are more driven by chronological aging or the menopause transition (MT) has been debated. We sought to determine whether women can be classified into distinct trajectory groups based on pattern and level of systolic (SBP), diastolic blood pressure, pulse pressure (PP), and mean...
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Objective: Longer menstrual cycles have been associated with greater risk of cardiovascular disease, supporting a contribution of abnormal ovarian function. We aimed to characterize trajectories of menstrual cycle length over the menopause transition (MT) and test whether these trajectories are associated with postmenopausal markers of subclinical...
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Background Younger age at final menstrual period (FMP) is associated with increased risk for cardiovascular disease events. This paper evaluated whether older age at FMP is associated with more favorable patterns of lipid changes during the menopause transition and whether these changes are associated with less subclinical carotid disease in the po...
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Context Novel metrics of HDL (subclasses, lipid content and function) may better characterize the anti-atherogenic features of HDL. In midlife women, changes in these metrics vary by time relative to the final menstrual period (FMP), supporting a contribution of menopause hormones estradiol (E2) and follicle-stimulating hormone (FSH). Objective To...
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Background Our study examined whether the early-onset depression phenotype among young adults (probands) is associated with the metabolic syndrome (MetS) and its components, and if MetS characterizes unaffected but high-risk siblings of probands. Methods We studied three groups of young adults ( M age = 25 years, s.d. = 3.84 years): probands with...
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The cardioprotective association of high-density lipoprotein cholesterol (HDL-C) may vary by menopause stage or estradiol level. We tested whether associations of comprehensive HDL metrics [HDL subclasses, phospholipid and triglyceride content and HDL cholesterol efflux capacity (HDL-CEC)] with coronary artery calcium (CAC) score and density vary b...
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Background Individuals engage in a range of behaviors to maintain close relationships. One behavior is self-silencing or inhibiting self-expression to avoid relationship conflict or loss. Self-silencing is related to poor mental health and self-reported physical health in women but has not been examined in relation to cardiovascular health, particu...
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Study Objectives To evaluate how change in menopausal status related to spectral analysis and polysomnographic measures of sleep characteristics. Methods The Study of Women’s Health Across the Nation (SWAN) Ancillary Sleep Study evaluated sleep characteristics of 159 women who were initially pre- or early perimenopausal and repeated the assessment...
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Objectives The literature on childhood-onset depression and future compromised vascular function is suggestive but limited. The objective of this study was to determine if arterial stiffness, a predictor of future cardiovascular disease (CVD), measured in young adulthood, is associated with childhood-onset depression. Methods Cardiometabolic risk...
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Objective: Higher levels of high-density lipoprotein cholesterol (HDL-C) may not always be cardio-protective in midlife women. Novel metrics of HDL including nuclear magnetic resonance (NMR) spectroscopy subclasses (large, medium and small HDL particles (HDL-P), and size), HDL content of phospholipids (HDL-PL) and triglycerides (HDL-Tg), and HDL fu...
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Knowledge of the association between air pollution and atherosclerosis risk has been generated in the general population. Our study targeted middle-aged women during the menopause transition who might be vulnerable to PM2.5 on CAC risk, due to their unique physiological profiles. We assessed the association of PM2.5 and CAC presence/progression in...
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Objective: In midlife women, higher high-density lipoprotein cholesterol (HDL-C) is not always associated with cardio-protection, suggesting a potential dysfunction of HDL. Novel metrics of HDL may provide further information on its cardio-protective features. The AHA developed the Life’s Simple 7 (LS7) score based on 7 lifestyle factors (cholester...
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Introduction Sleep continuously changes over the human lifespan and it does so across multiple dimensions, including duration, timing, efficiency, and variability. Although studies focused on specific developmental periods have shown age-related changes in sleep, methodological differences make it difficult to synthesize information across studies...
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Objective To evaluate the roles of parenting and adolescent characteristics during ages 13 to 16 in connecting family socioeconomic status (SES) during adolescence with adult sleep in Black and White men. Design Longitudinal school-based community study beginning in 1987-1988 when participants were enrolled in the first or seventh grade. Setting...
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This longitudinal study examines whether early experiences with caregivers between the ages of 10 and 12 are associated with later adolescent personality at age 16 using both parent and child reports. Lower positive parenting was prospectively associated with higher neuroticism and lower extraversion and conscientiousness for both parent and self‐r...
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Background Cardiovascular risk factors (CVRFs) are associated with increased risk of cognitive decline, but little is known about how early adult CVRFs and those across the life course might influence late-life cognition. To test the hypothesis that CVRFs across the adult life course are associated with late-life cognitive changes, we pooled data f...
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Study Objectives Examine the association between trajectories of self-reported insomnia symptoms and sleep duration over 13 years with objective physical function. Methods We utilized data from 1627 Study of Women’s Health Across the Nation (SWAN) participants, aged 61.9±2.7 y at the end of the 13-y follow-up. Latent class growth models identified...
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Objective: Evidence suggests that insulin deficiency and hyperglycemia may disrupt the female reproductive system's normal function, leading to delayed menarche and premature ovarian aging. We thus compared the length of the reproductive period of women with type 1 diabetes (T1D) to women without diabetes. Methods: Women with childhood-onset T1D...
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Objectives: To characterize abdominal visceral adipose tissue (VAT) trajectory relative to the final menstrual period (FMP), and to test whether menopause-related VAT accumulation is associated with greater average, common carotid artery intima-media thickness (cIMT) and/or internal carotid artery intima-media thickness (ICA-IMT). Methods: Parti...
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Introduction: Cardiovascular risk factors in midlife have been linked to late life risk for Alzheimer's disease and related dementias (ADRD). The relation of vascular risk factors on cognitive decline within midlife has been less studied. Methods: Using data from the Study of Women's Health Across the Nation, we examined associations of midlife...
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Objective: To examine whether blood pressure (BP) accelerates more rapidly during the menopause transition for women with a history of preterm or term small for gestational age (SGA) delivery compared to women with all term and appropriate for gestational age (AGA) births. Methods: A longitudinal analysis was conducted with 1,008 parous women wh...
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Background Cardiovascular disease (CVD) in women has unique features, including associations with reproductive factors that are incompletely understood. Vasomotor symptoms (VMS), the classic menopausal symptom, are linked to CVD risk factors and subclinical CVD. Evidence linking VMS to CVD events is limited. We tested whether frequent and/or persis...
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Background Depressive symptoms and sleep disturbances disproportionately affect midlife women. While there may be a bidirectional association, few studies have examined whether depressive symptoms are longitudinally associated with subsequent sleep. Sleep is typically considered unidimensional, despite emerging evidence that multidimensional sleep...
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Objective: Studies suggest a reversal in the protective association of high-density lipoprotein cholesterol (HDL-C) and cardiovascular disease in women traversing menopause. Decreasing estrogen levels during the transition, as well as inflammation, may explain this reversal. We tested whether either estradiol or C-reactive protein (CRP) concentrat...
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Background Most women occupy multiple social roles during midlife. Perceived stress and rewards from these roles may influence health behaviors and risk factors. This study examined whether social role stress and reward were associated with the American Heart Association Life’s Simple 7 in a cohort of midlife women in the United States. Methods an...
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Background The menopausal transition (MT) poses an increased risk for major depression (MD), but not for all women. Current and past stress are toxic risk factors for depression throughout life. The MT may be a time of increased sensitivity to stress, especially among women with a lifetime history of major depressive disorder (MDD). We evaluated wh...
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Objective The cardioprotective capacity of HDL (high-density lipoprotein) cholesterol postmenopause has been challenged. HDL subclasses, lipid contents, and function might be better predictors of cardiovascular risk than HDL cholesterol. Changes in these measures have not been characterized over the menopause transition (MT) with respect to timing...
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Depression may be an important risk factor for dementia, but findings are controversial, partially because depression may be an early symptom of dementia. Most studies have only assessed depression symptoms at mid or late‐life, although depression can be a lifelong illness and effects may differ over the life‐course, with important prevention impli...
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African-American women have elevated rates of cardiovascular disease compared to women of other race/ethnicities, and race/ethnicity-related stressors may play a role. We examined the association between an understudied race/ethnicity-related stressor, midlife loss (e.g. deaths of friends/family members) and a marker of cardiovascular risk, carotid...
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Objective: To identify groups of women who share levels and patterns of change in follicle-stimulating hormone (FSH), self-reported sleep maintenance problems, and frequent vasomotor symptoms (VMS) up to 10 years before and after their final menstrual period and to evaluate their premenopausal characteristics. Method: Group-based multi-trajector...
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Importance: Early menarche and early menopause are associated with increased risk of cardiovascular disease (CVD) in midlife, but little is known about the association between reproductive life span and the risk of CVD. Objective: To investigate the association between the length of reproductive life span and risk of incident CVD events, while a...
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Study objectives: To determine whether actigraphy-assessed indices of sleep are associated with cognitive performance in women, and explore whether these associations vary by race/ethnicity. Methods: Participants were 1,126 postmenopausal community-dwelling females (mean age 65 years) from the observational Study of Women's Health Across the Nat...
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Improvements in cardiovascular disease (CVD) rates among young adults in the past 2 decades have been offset by increasing racial/ethnic and gender disparities, persistence of unhealthy lifestyle habits, overweight and obesity, and other CVD risk factors. To enhance the promotion of cardiovascular health among young adults 18 to 39 years old, the m...
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The evening chronotype is strongly associated with greater alcohol use, though mechanisms underlying this association are not well understood. The current study evaluated emotion regulation as a potential mechanism linking evening chronotype and alcohol use. Participants were 81 undergraduate students. Chronotype was assessed using the Composite Sc...
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Objective: To determine whether women with a history of nulliparity, hypertensive disorders of pregnancy (HDP), or gestational diabetes mellitus (GDM) have a higher odds of reporting vasomotor symptoms (VMS) at midlife. Methods: A longitudinal analysis was performed with 2,249 women with pregnancy history data in the Study of Women's Health Acro...
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Objective: The current meta-analysis tested whether trait indicators of well-being associate with stressor-evoked physiological reactivity and recovery in healthy adults. Method: Medline, PsycINFO, and PubMed were used to identify relevant articles. Articles were included if they (a) measured cardiovascular or neuroendocrine (but not immune) phy...
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Background A greater frequency of vasomotor symptoms (VMS) has been associated with higher low-density lipoprotein cholesterol (LDL-C), but the association with high-density lipoprotein cholesterol (HDL-C) remains unclear. Endogenous estradiol (E2) levels are associated with both VMS and lipid levels, and thus, may confound such associations. Obje...
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Objectives The association between sleep and adiposity (indexed by body mass index or waist-to-hip ratio) has typically been evaluated using a single dimension of self-reported sleep. However, other dimensions and behavioral measures of sleep may also be associated with adiposity. This study evaluated whether multidimensional sleep health calculate...
Article
Evidence suggests that insulin deficiency and hyperglycemia may disrupt the normal function of the female reproductive system, leading to delayed menarche and premature ovarian aging. We compared the length of the reproductive period of women with T1D and women without diabetes. We assessed age at menarche and natural menopause in women with childh...
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Objective: The present study evaluated distinct facets of impulsivity related to cardiometabolic risk (CMR) to identify specific behavioral mechanisms driving these relationships. Method: Community adults (N = 1,295) between 30 and 54 years old (53% female, 84% White) completed a battery of impulsivity measures, reported their engagement in heal...
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Objective: Higher levels of high-density lipoproteins cholesterol (HDL-C) may not always be cardio-protective in midlife women. Nuclear magnetic resonance (NMR) spectroscopy HDL subclasses have shown strong associations with CVD risk beyond HDL-C. Preliminary work suggests significant declines in large HDL particles (HDL-P) and overall HDL size, bu...
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Objective: High density lipoprotein (HDL) is emerging as a key player in modulating inflammation-related response impacting atherosclerosis development. HDL carries multiple proteins with direct roles in complement system activation including C3 and C4. Postmenopausal women have higher levels of C3 than premenopausal women suggesting a role of the...
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In this study, we investigate the associations of objectively measured waking (sedentary, light physical activity [LPA] and moderate-to-vigorous physical activity [MVPA]) and sleep duration and quality characteristics with cardiometabolic risk among older women. Participants from the Healthy Women Study 2010-11 follow-up visit (n=136, age=73±2 year...
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Background The extent to which cardiovascular disease ( CVD ) risk factors across the menopause explain racial/ethnic differences in subclinical vascular disease in late midlife women is not well documented and was explored in a multi‐ethnic cohort. Methods and Results Participants (n=1357; mean age 60 years) free of clinical CVD from the Study of...
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Objective Evidence links trait hostility with components of the metabolic syndrome (MetS), a clustering of cardiometabolic risk factors, but which hostility dimensions (e.g., expressive or cognitive hostility) relate to MetS are not well known. Further, there may be age and sex differences in the extent to which hostility dimensions relate to MetS....
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Objective: Menopause may augment age-dependent increases in arterial stiffness, with black women having greater progression in midlife compared with white women. We sought to determine whether and when women experience changes in arterial stiffness relative to the final menstrual period (FMP) and whether these changes differ between black and whit...
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Although resting heart rate is thought to be a generalizable risk factor for aggression, very little research has examined whether this relationship varies by race. We addressed this limitation using longitudinal data from the Pittsburgh Youth Study. Current data are from 197 men who participated in a teenage biosocial study (mean age = 15.7 years)...
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Objective: Telomeres are protective sequences of DNA capping the ends of chromosomes that shorten over time. Leukocyte telomere length (LTL) is posited to reflect the replicative history of cells and general systemic aging of the organism. Chronic stress exposure leads to accelerated LTL shortening, which has been linked to increased susceptibilit...
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Objective: Investigate temporal patterns of sleep maintenance problems in women who became surgically menopausal (hysterectomy with bilateral oophorectomy) before their final menstrual period and examine whether presurgery trajectories of sleep maintenance problems are related to problems staying asleep postsurgery. Methods: Longitudinal analysi...
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Traumatic experiences are common and linked to cardiovascular disease (CVD) risk, yet the mechanisms underlying these relationships is less well understood. Few studies have examined trauma exposure and its relation to autonomic influence over cardiac function, a potential pathway linking trauma exposure to CVD risk. Investigating autonomic influen...
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Full-text available
Background: Early menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence and timing of cardiovascular disease is unclear. We aimed to assess the associations between age at natural menopause and incidence and timing of cardiovascular disease. Methods: We harmonise...
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Our study objectives were to evaluate the age-related changes in actigraphy measures of sleep duration, continuity, and timing across 12 years in midlife women as they traversed the menopause, and to take into account factors affecting women’s sleep that also change with age. Black, White, and Chinese women were recruited from the Study of Women’s...
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Full-text available
Background: Early menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence and timing of cardiovascular disease is unclear. We aimed to assess the associations between age at natural menopause and incidence and timing of cardiovascular disease. Methods: We harmon...
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Full-text available
Objective: Our initial understanding of the menopause transition (MT) has been framed by clinical samples of women seeking treatment rather than by population-based studies. The Study of Women's Health Across the Nation (SWAN) initiated in 1996 with an overall goal to define the MT, to characterize its biological and psychosocial antecedents and s...
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Background and aims: Reproductive factors are associated with later life CVD in women (e.g., age at first birth, preeclampsia, gestational diabetes), but studies have focused largely on premenopausal women. We examined the relationship of reproductive factors with subclinical CVD burden in late midlife women. Methods: We included 964 parous wome...
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Objective: The purpose of this study was to determine if mid-life social role quality, defined by the stress and rewards associated with four social roles, is related to later-life subclinical cardiovascular disease (SCVD) in a cohort of women transitioning through menopause. Methods: The Study of Women's Health Across the Nation (SWAN) is a lon...