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Another study links early menopause to cardiovascular disease

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Menopause is inevitable for all women; it usually occurs during the late 40s or early 50s. An early menopause—one occurring before the normal range––not only results in an earlier onset of unpleasant symptoms, such as hot flashes, vaginal dryness, and mood changes, but also has health consequences. Another study has found a link between early menopause and cardiovascular disease. The findings were published on the June edition of the journal Menopause.

The goal of the study was to assess the relationships of early menopause (menopause occurring before age 45 years) and age at menopause with heart failure in postmenopausal women. They also evaluated the associations of early menopause and age at menopause with left ventricular (left heart pumping chamber) measures of structure and function in postmenopausal women.

The study group comprised 2,947 postmenopausal women, aged 45 to 84 years who did not have a history of cardiovascular disease. The women were enrolled in the Multi-Ethnic Study of Atherosclerosis; data was gathered from 2000 through 2002. The data was subjected to statistical analysis to assess the associations of early menopause and age at menopause with heart failure. Among 2,123 postmenopausal women in whom cardiac magnetic resonance imaging (MRI) was obtained at baseline, the researchers investigated the associations of early menopause and age at menopause with left ventricular measurements.

The women were followed for an average of 8.5 years; during this period 71 heart failure events occurred. No relationship between ethnicity and heart failure was found. Early menopause was associated with an increased risk of heart failure (1.66-fold increased risk); each one-year increase in age at menopause was related to a decreased risk heart failure (0.96-fold decreased risk). The investigators found significant relationships between early menopause and ethnicity for left ventricular mass-to-volume ratio (LVMVR). In Chinese-American women, early menopause was associated with a higher LVMVR; however, each one-year increase in age at menopause was related to a lower LVMVR at baseline.

The authors concluded that older age at menopause is independently associated with a decreased risk of heart failure. Concentric (having a common axis) left ventricular remodeling, specified by a higher LVMVR, is present in Chinese-American women who experienced early menopause at baseline.

Take home message:

An early menopause can be due to both genetic and environmental factors. Genetic factors are beyond a woman’s control; however, some environmental factors can be modified. Smoking has been reported to result in an earlier menopause, and most likely, other poor lifestyle choices may have an effect. Chemotherapy for a malignancy can result in an early menopause.

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