Early menopause is associated with increased risk of arterial hypertension: A systematic review and meta-analysis

Anagnostis, Panagiotis; Theocharis, Patroklos; Lallas, Konstantinos; Konstantis, Georgios; Mastrogiannis, Κonstantinos; Bosdou, Julia K.; Lambrinoudaki, Ιrene; Stevenson, John C.; Goulis, Dimitrios G.

doi:10.1016/j.maturitas.2020.03.006

Cited by 52 publications

(36 citation statements)

References 39 publications

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“…Hypertension increases with advancing age; younger women have a lower BP than men of a similar age but, as women transition through the menopause, BP tends to increase such that it is greater in women over the age of 55 years than in men [39]. A recent meta-analysis showed a significantly greater prevalence (around 30%) of hypertension in women with early menopause (<45 years) compared with women with normal-age menopause (>45 years) [40]. Hypertension increases the risk of CHD and stroke, and, if uncontrolled, results in end-stage renal disease [38].…”

Section: Blood Pressurementioning

confidence: 99%

Cardiometabolic health in premature ovarian insufficiency

et al. 2021

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Premature ovarian insufficiency (POI) is an increasing public health problem with a prevalence now approaching 4%. POI results in adverse effects on the skeleton and central nervous system as well as disturbances of metabolic and cardiological factors that predispose to a major increased risk of cardiovascular disease (CVD). This article reviews the effects of the premature loss of ovarian function on lipids and lipoproteins, glucose and insulin metabolism, body composition, hemostasis and blood pressure, together with effects on the development of metabolic syndrome and diabetes mellitus. The article examines the effects of POI on vascular endothelial function and inflammation that result in arterial disease, and reviews the effects of hormone replacement therapy (HRT) on these various metabolic processes and on cardiovascular outcomes. It is essential that women with POI receive hormonal treatment to help prevent the development of CVD, and that this treatment is continued at least until the normal age of menopause. It appears that HRT has a more favorable effect than the combined oral contraceptive, but larger clinical trials are needed to establish the optimal treatment. Other therapeutic measures may need to be added to correct existing metabolic abnormalities and, in particular, attention to lifestyle factors such as diet and exercise must be encouraged.

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Section: Blood Pressurementioning

confidence: 99%

Cardiometabolic health in premature ovarian insufficiency

et al. 2021

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“…Menopause onset is considered an independent marker of cardiovascular disease and mortality risk in women [ 5 ]. Early onset of menopause (e.g., <45 years), has been associated with high BP in several populations [ 6 , 7 ] and could increase cardiovascular disease risk observed in this group of women [ 5 , 6 ]. Nevertheless, the results of the association between age at menopause and BP traits are not consistent across studies [ 6 , 8 , 9 ], and causal association of age at menopause with BP has not been clarified [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Age at Natural Menopause and Blood Pressure Traits: Mendelian Randomization Study

Roa‐Díaz

Asllanaj

Amin

et al. 2021

JCM

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Observational studies suggest that early onset of menopause is associated with increased risk of hypertension. Whether this association is causal or due to residual confounding and/or reverse causation remains undetermined. We aimed to evaluate the observational and causal association between age at natural menopause (ANM) and blood pressure traits in Caucasian women. A cross-sectional and one-sample Mendelian randomization (MR) study was conducted in 4451 postmenopausal women from the CoLaus and Rotterdam studies. Regression models were built with observational data to study the associations of ANM with systolic and diastolic blood pressure (SBP/DBP) and hypertension. One-sample MR analysis was performed by calculating a genetic risk score of 54 ANM-related variants, previously identified in a genome-wide association study (GWAS) on ANM. In the two-sample MR analysis we used the estimates from the ANM-GWAS and association estimates from 168,575 women of the UK Biobank to evaluate ANM-related variants and their causal association with SBP and DBP. Pooled analysis from both cohorts showed that a one-year delay in menopause onset was associated with 2% (95% CI 0; 4) increased odds of having hypertension, and that early menopause was associated with lower DBP (β = −1.31, 95% CI −2.43; −0.18). While one-sample MR did not show a causal association between ANM and blood pressure traits, the two-sample MR showed a positive causal association of ANM with SBP; the last was driven by genes related to DNA damage repair. The present study does not support the hypothesis that early onset of menopause is associated with higher blood pressure. Our results suggest different ANM-related genetic pathways could differently impact blood pressure.

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“…[44] Third, the mechanisms underlying menopause transition and CMD associations are not well understood, data are mainly based on traditional risk factors, and few on novel pathways that explain the association between menopause and CMD. [5,45,46] Alternative mechanisms, such as iron metabolism, the role of environmental factors, and the possible role of DNA damage response mechanisms in the association of menopausal and CVD, are some of the emerging hypotheses. [47,48] 4.…”

Section: Menopause Characteristics and Cmd Riskmentioning

confidence: 99%

“…[2,3] However, the underlying biological pathways remain insufficiently studied, and disentangling the effect of age and menopause on cardiometabolic status worsening has been challenging. [4,5] Considering that the midlife period could be a critical window of opportunity to optimize cardiometabolic health and initiate early prevention strategies, we conducted a narrative review in which we discuss the current understanding of the impact of menopause (timing, type and menopause stages) and associated modifying and/or mediating factors such as hormone therapy, genes, lifestyle and environment on CMD risk (e.g., risk factors such as blood pressure, lipid and glucose metabolism, obesity and T2D and CVD) in aging women.…”

Section: Introductionmentioning

confidence: 99%

Menopause and cardiometabolic diseases: What we (don't) know and why it matters

et al. 2021

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Early menopause is associated with increased risk of arterial hypertension: A systematic review and meta-analysis

Cited by 52 publications

References 39 publications

Cardiometabolic health in premature ovarian insufficiency

Cardiometabolic health in premature ovarian insufficiency

Age at Natural Menopause and Blood Pressure Traits: Mendelian Randomization Study

Menopause and cardiometabolic diseases: What we (don't) know and why it matters

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