Takeaway
- People who have premature menopause (<40 years), whether naturally or because of surgery, have increased risk for a composite of cardiovascular diseases (CVDs).
- Risk is slightly higher with surgically induced menopause.
Why this matters
- Although guidelines suggest asking about history of early menopause in women, “robust data” on the association have been lacking, these authors say.
Key results
- Primary composite CVD outcome occurred in:
- 3.9% women with no premature menopause.
- 6.0% with natural premature menopause.
- 7.6% with surgically induced premature menopause.
- These groups differed significantly (P<.001).
- HR with natural premature menopause, 1.36 (95% CI, 1.19-1.56; P<.001).
- HR with surgically induced premature menopause, 1.87 (95% CI, 1.36-2.58; P<.001).
- Authors also found significant associations (aHRs) of premature natural menopause with:
- Venous thromboembolism: 1.70 (P<.001).
- Aortic stenosis: 2.37 (P<.001).
- Ischaemic stroke: 1.50 (P=.04).
- Coronary artery disease: 1.39 (P=.02).
- Afib: 1.25 (P=.05).
- But not with heart failure, mitral regurgitation, or peripheral artery disease.
- Premature surgical menopause was associated (aHRs) with:
- Mitral regurgitation: 4.13 (P=.002).
- Venous thromboembolism: 2.73 (P=.002).
- Heart failure: 2.57 (P=.01).
- Coronary artery disease: 2.52 (P<.001).
Study design
- Analysis of UK Biobank data for 144,260 postmenopausal women aged 40-69 years (natural premature menopause, 4904; surgical premature menopause, 644).
- Median follow-up, 7 years.
- Funding: National Heart, Lung, and Blood Institute; others.
Limitations
- Small event numbers.
- No causation established.
References
References
