Premature Menopause May Independently Predict Pulmonary Hypertension Risk

Takeaway

• Premature menopause (occurring before age 40 years) was independently associated with a 2-fold risk of pulmonary hypertension (PH).
• Further increase in PH risk was seen with progressively earlier age at menopause.

Why this matters

• Further investigation of the role of sex hormones in PH is required to elucidate pathobiology and identify novel therapeutic targets.

Study design

• This cohort study included 136,715 postmenopausal women (age, 40-69 years; 5201 (3.8%) had premature menopause) from the UK Biobank who were followed up for a median of 11.1 years (interquartile range, 10.5-11.8).
• Primary outcome: incident PH.
• Funding: None.

Key results

• A total of 447 women (overall cumulative incidence, 0.33%) were diagnosed with incident PH (38 [0.73%] women with premature menopause and 409 [0.31%] without).
• After adjustments, premature menopause was independently associated with an increased risk of PH (adjusted HR [aHR], 2.13; 95% CI, 1.31-3.23; P<.001).
• The risk of PH increased progressively with younger age at menopause (P_trend<.001).
• Compared with women who experienced menopause after age 50 years, the risk of PH was higher with menopause before age 30 years (HR, 4.82; 95% CI, 1.82-12.74; P=.002).
• Ever use of menopausal hormonal therapy was not associated with incident PH (aHR, 0.90; 95% CI, 0.73-1.12; P=.36) and did not modify the association of premature menopause with PH (P_interaction=.63).

Limitations

• Incident PH diagnoses were determined from International Classification of Disease codes rather than invasive haemodynamics.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.