Premature menopause linked to substantial long-term heart risks
Premature menopause is associated with a significantly higher lifetime risk of heart disease, according to new data published in JAMA Cardiology.[1]
Previous studies have confirmed that premature menopause—menopause that starts before the age of 40 years old—increases a woman’s short-term risk of heart disease. The team behind this analysis hoped to learn what premature menopause means in terms of long-term risks.
To find out, the group examined data from the Cardiovascular Disease Lifetime Risk Pooling Project. Women between the ages of 55 and 69 years old were included, and the researchers stratified those women by their age at the onset of menopause.
In total, this study included more than 6,500 white women and more than 3,500 Black women. The mean ages for those groups were 61.2 years old and 60 years old, respectively. The rates of premature menopause, meanwhile, were 15.5% and 4.8%, respectively. All patients were free of coronary heart disease (CHD) at the start of the study.
Overall, premature menopause was associated with a 40% higher lifetime risk of CHD for these women. Also, the mean years lived free of CHD for Black women were 18.2 if they had premature menopause and 19.1 if they did not have premature menopause. A similar trend was seen in white women, the authors noted, but the difference was not statistically significant.
“These findings quantify the lifetime risk of CHD in women with premature menopause,” wrote first author Priya M. Freaney, MD, a cardiologist with Northwestern Medicine and assistant professor of cardiology with Northwestern University Feinberg School of Medicine, and colleagues
The researchers also said these findings may help partially explain patterns healthcare researchers have been tracking for many years.
“This work also raises the question whether the higher frequency of premature menopause observed in Black women may contribute in part to known disparities in CHD between Black and white women,” they wrote. “While the etiology of premature menopause is not known, it is likely variable between racial groups and is associated with a variety of genetic, biological, and environmental factors, including early menarche, health behaviors, obesity, and weathering. It remains unclear if the menopausal transition truly represents a more disease-permissible vascular environment or whether those who experience premature menopause are the same individuals who already have a disease-permissible vascular environment where risk is unmasked and premature menopause is a marker. However, these data support the perimenopausal period as a unique window of opportunity to measure, monitor, and modify CVD risk in women.”
One noteworthy limitation of this research was the fact that researchers were unable to consistently confirm whether or not these women started hormone therapy. The potential role of hormone therapy is a key aspect of this conversation, however, and the group emphasized that it remains an “important topic for future analyses.”
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Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.