SAN DIEGO — Women who go through menopause before the age of 46 are twice as likely to have a heart attack, stroke, or other cardiovascular event later in life as are women who do not go through early menopause, results from a large, multiethnic study showed.
“Our study is observational, so we cannot conclude that early menopause somehow causes these cardiovascular disease events, but our findings support using early menopause as a marker of increased cardiovascular disease risk,” Dr. Melissa F. Wellons said during a press briefing at the meeting. “Therefore, getting clinicians to ask women about menopause and about when they went through menopause is an important part of potentially determining what their risk of CVD is in the future. Doing that can give them information on placing these women with early menopause into a higher risk group and counseling them appropriately, such as encouraging them to stop smoking, exercise, and lose weight.”
Dr. Wellons, a fellow in the department of medicine at the University of Alabama, Birmingham, and her associates evaluated data from 2,509 women enrolled in the observational Multi-Ethnic Study of Atherosclerosis (MESA), funded by the National Institutes of Health. It included more than 6,000 women, from six communities in the United States, who were recruited in 2000 and followed for an average of 7 years. Most (40%) were white, 25% were black, 22% were Hispanic, and 13% were Chinese American.
The researchers defined early menopause as occurring before age 46, either naturally or surgically through removal of both ovaries, and they tracked the incidence of CVD among all study participants. This included heart attack, nonfatal cardiac arrest, a definite angina, probable angina (if followed by revascularization), a stroke, or death due to stroke, heart attack, or other cardiovascular disease.
At baseline, the women ranged in age from 45 to 84 years. Of the 2,509 women, 693 (28%) reported early menopause. Of these, 446 (64%) had natural menopause and 247 (36%) had surgical menopause.
In the early menopause group, 41 women (5.9%) had CVD events during the study period. Among those who did not have early menopause, 47 women (2.6%), had CVD events. The difference was significant.
No woman in either group had a CVD event before the age of 55.
After adjusting for race/ethnicity, level of education, smoking history, hypertension, total cholesterol, HDL cholesterol, diabetes, and whether the menopause was natural or surgical, Dr. Wellons and her associates found that women in the early menopause group were 2.1 times more likely to experience a CVD event, compared with women who did not have early menopause. Further adjustment for current or previous use of hormone replacement therapy and body mass index produced identical results.
Dr. Wellons was the recipient of an NHLBI Career Development Award.
'Our findings support using early menopause as a marker of increased cardiovascular disease risk.'
Source DR. WELLONS