Heart Disease Risk Determines Menopausal Age Rather Than the Reverse
- 24 April 2006
- journal article
- Published by Elsevier BV in Journal of the American College of Cardiology
- Vol. 47 (10), 1976-1983
- https://doi.org/10.1016/j.jacc.2005.12.066
Abstract
Objectives: The purpose of this study was to investigate whether a harmful cardiovascular risk profile accelerates menopause. Background: Women with an early menopause are at an increased risk of cardiovascular disease. Although increased cardiovascular risk has been proposed as consequence of menopause, the alternative hypothesis, that increased premenopausal cardiovascular risk promotes early menopause, needs to be examined. Methods: We used data from the Framingham Heart Study cohort. This study started in 1948 and has followed up participants biennially since then. Women who were premenopausal at study entry and who reached natural menopause after at least two examination rounds were included in the study (n = 695). Premenopausal age-independent levels of serum total cholesterol, relative weight, blood pressure, and Framingham risk score were determined, as well as premenopausal changes in cholesterol, body weight, and blood pressure. Results: A higher premenopausal serum total cholesterol level was statistically significantly associated with an earlier age at menopause, as were increases in total serum cholesterol, relative weight, and blood pressure in the premenopausal period. A decrease in total serum cholesterol during premenopause was statistically significantly associated with later age at menopause. Decreasing blood pressure was associated with a later menopausal age, but this association was not statistically significant. A decrease in relative weight was associated with a significant earlier age at menopause. Each 1% higher premenopausal Framingham risk score was associated with a decrease in menopausal age of 1.8 years (95% confidence interval −2.72 to −0.92). Conclusions: The findings support the view that heart disease risk determines age at menopause. This offers a novel explanation for the inconsistent findings on cardiovascular disease rate and its relationship to menopausal age and effects of hormone replacement therapy.This publication has 40 references indexed in Scilit:
- Intention to Lose Weight, Weight Changes, and 18-y Mortality in Overweight Individuals without Co-MorbiditiesPLoS Medicine, 2005
- Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women's Health Initiative Randomized Controlled TrialJAMA, 2002
- Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)JAMA, 2001
- Randomized Trial of Estrogen Plus Progestin for Secondary Prevention of Coronary Heart Disease in Postmenopausal WomenJAMA, 1998
- Estrogen replacement therapy and coronary heart disease: A quantitative assessment of the epidemiologic evidencePreventive Medicine, 1991
- Effects of bilateral oophorectomy on lipoprotein metabolismBJOG: An International Journal of Obstetrics and Gynaecology, 1990
- Menopause and Risk Factors for Coronary Heart DiseaseNew England Journal of Medicine, 1989
- REPRODUCIBILITY AND VALIDITY OF SELF-REPORTED MENOPAUSAL STATUS IN A PROSPECTIVE COHORT STUDYAmerican Journal of Epidemiology, 1987
- Increased 2-Hydroxylation of Estradiol as a Possible Mechanism for the Anti-Estrogenic Effect of Cigarette SmokingNew England Journal of Medicine, 1986
- Some methodologic problems in the long-term study of cardiovascular disease: Observations on the Framingham studyJournal of Chronic Diseases, 1959