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 The findings suggest that age at menopause may help predict women's
risk for future health problems, said lead author Dr. Taulant Muka,
of Erasmus University Medical Center in Rotterdam, The Netherlands.
"Women with early onset of menopause may be a group to target for
proactive cardiovascular prevention strategies," Muka told Reuters
Health in an email.
One in 10 women enter so-called natural menopause by age 45, Muka
and colleagues write in JAMA Cardiology. Natural menopause is when
the ovaries spontaneously reduce or cease production of certain
hormones, like estrogen. Menopause can also be brought on by surgery
and other medical issues.
Muka's team looked at data on more than 310,000 women who had
participated in a total of 33 studies published since the 1990s.
Comparing women who had their last period before age 45 to those who
entered menopause at age 45 or older, the researchers found women
with earlier menopause had a 50 percent higher risk of coronary
heart disease, which can cause chest pain, heart attacks and strokes
as plaque builds up on the walls of arteries.
Women who entered menopause before age 45 were also about 20 percent
more likely than women with later menopause to die from
cardiovascular disease (including heart attacks and strokes).
Women who entered menopause early were also 12 percent more likely
to die of any cause while researchers were tracking them, compared
to women who entered menopause later.
In a second analysis comparing women who entered menopause before
age 50 to women who entered menopause between ages 50 and 54, the
later-menopause group had a reduced risk of deadly coronary heart
disease.
Muka said the timing of menopause may influence the risk of heart
disease and other health problems through hormones. Additionally, he
said, menopause may be a sign of overall aging.
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"Our results indicate that menopause might be a critical period to
evaluate women’s risk for future cardiovascular events and that it
may be an appropriate time to introduce interventions to reduce the
risk," said Muka.
For example, he said, women who enter menopause early may want to
work on controlling their blood pressure, cholesterol, blood sugar
and other factors affecting their heart health.
Women in Western populations enter menopause at an average age of
51, write Dr. JoAnn Manson, of Brigham and Women's Hospital in
Boston, and Teresa Woodruff, of Northwestern University in Chicago,
in an editorial accompanying the new analysis.
Professional societies agree that women with early menopause should
be considered for hormone therapy - if eligible - to manage symptoms
and protect bone and vascular health, Manson and Woodruff write.
"The recognition that women with early reproductive decline
constitute a population at increased vascular risk provides
important opportunities for early intervention in terms of both risk
factor modification and, when appropriate, hormonal treatment," they
note.
The new analysis aligns with a July study in the journal Menopause
that found women who start their periods later and have later
menopause are more likely to reach age 90 than those whose
reproductive milestones come at earlier ages.
SOURCE: http://bit.ly/2d2Rwat and http://bit.ly/2d2RRtQ JAMA
Cardiology, online September 14, 2016.
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