Age at menopause and incident heart failure

Abstract

Objective To evaluate associations of early menopause (menopause occurring before 45 years of age) and age at menopause with incident heart failure (HF) in post-menopausal women. We also explored associations of early, and age at menopause with left ventricular (LV) measures of structure and function in post-menopausal women. Methods We included 2947 post-menopausal women, aged 45-84 years, without known cardiovascular disease (2000-2002), from the Multi-Ethnic study of Atherosclerosis. Cox-Proportional hazards models were used to examine associations of early, and age at menopause with incident HF. In 2123 post-menopausal women in whom cardiac magnetic resonance imaging was obtained at baseline, we explored associations of early, and age at menopause with LV measures using multivariable linear regression. Results Over a median follow-up of 8.5 years, we observed 71 HF events. There were no significant interactions with ethnicity for incident HF (Pinteraction>0.05). In adjusted analysis, early menopause was associated with increased risk of incident HF [1.66 (1.01-2.73)], while each year increase in age at menopause was associated with decreased risk of incident HF [0.96 (0.94-0.99)]. We observed significant interactions between early menopause and ethnicity for LV mass to volume ratio (LVMVR), Pinteraction=0.02. In Chinese-American women, early menopause was associated with higher LVMVR (+0.11, p=0.0002), while each year increase in age at menopause was associated with lower LVMVR (−0.004, p=0.04) at baseline. Conclusion An older menopausal age is independently associated with decreased risk of incident HF. Concentric LV remodelling, indicated by a higher LVMVR was present in Chinese-American women with early menopause at baseline.

A Life Course Perspective on Body Size and Cardio-metabolic Health

“…Various markers of the pace of pubertal development have been reported to be associated with various cardio-metabolic health outcomes in both sexes (see section "Adolescence"). Interestingly, an early age at menopause, which marks the cessation of a women's reproductive ability, is also associated with increased risk for cardio-metabolic disease (Ebong et al 2014). Lifelong environmental conditions may influence the timing of menopause (Lawlor et al 2003), but it is unknown whether or not the biological changes that occur during menopause and impact on subsequent health are particularly sensitive to concurrent exposures.…”

Semelhanças Entre Comportamentos E Papéis Sociais Apresentados Por Mulheres E Homens Com Doença Arterial Coronariana

“…Como consequência, ocorre a diminuição da proteção estrogênica associada à perda da função ovariana, com consequente aumento dos fatores de risco para desenvolvimento de DAC. Essa deficiência estrogênica, tanto natural quanto cirúrgica, aumenta o risco de desenvolver DAC em até sete vezes, constituindo a principal causa de morte feminina pós-menopausa (16) . A crescente prevalência de fatores de risco e de doenças cardiovasculares em mulheres vem acompanhada da independência feminina e de sua participação no processo produtivo, seja no mercado de trabalho o ou como chefes de família, expondo-as aos comportamentos de risco, antes observados com maior frequência em homens (17) .…”

Association of menopause age and N-terminal pro brain natriuretic peptide

“…Women who had MRI were younger and had lower BMI. 4 In a subpopulation of MESA participants without LVH risk factors, the 95 th percentile cutoff of observed/predicted LVM of 1.31 has been accepted as corresponding to LVH. 32 BMI is an indicator of generalized obesity but does not distinguish between muscle or fat mass.…”

“…Early menopause has been linked with greater cardiovascular disease (CVD) risk, 1–3 and shown to be associated with a greater incidence of heart failure (HF), 4 coronary artery disease and stroke. 5 CVD is the leading cause of death in women 6 and early diagnosis is useful for optimization of care and improvement in therapy.…”