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Early age of Menopause risk for heart failure

7 July 2014

Published in Menopause, the journal of the North American Menopause Society, the study evaluated the associations of early menopause (menopause occurring before age 45 years) and age at menopause with incident heart failure (HF) in postmenopausal women. The associations of early menopause and age at menopause with left ventricular (LV) measures of structure and function in postmenopausal women were also explored.

2,947 postmenopausal women were included, aged 45 to 84 years without known cardiovascular disease, from the Multi-Ethnic Study of Atherosclerosis. The associations of early menopause and age at menopause with incident HF were examined. In addition, the associations of early menopause and age at menopause with LV measures in 2,123 postmenopausal women in whom cardiac magnetic resonance imaging was obtained at baseline, were explored.

Results showed that over follow-up of 8.5 years, early menopause was associated with an increased risk of incident HF, whereas every 1-year increase in age at menopause was associated with a decreased risk of incident HF. Significant interactions were observed between early menopause and ethnicity for measures of cardiac function.

The study reporters concluded that older age at menopause is independently associated with a decreased risk of incident HF. Concentric LV remodeling, affecting cardiac function, is present in Chinese-American women who experienced early menopause at baseline.

The relationship between age of menopause and cardiovascular disease has been long debated, and this study adds further evidence that not only can early menopause cause significant estrogen deficiency symptoms, but also have detrimental effects on the cardiovascular system. It is well known that estrogen has many beneficial effects on the cardiovascular system related to lipids, cholesterol, vascular and cardiac function and so it appears that loss of estrogen at an earlier age than normal increases risk such that early age at menopause may be an indicator of increased HF risk and signals a need for more frequent screening and aggressive risk factor modification.

Reference [82]

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