Limits...
Association of Age at Menopause With Incident Heart Failure: A Prospective Cohort Study and Meta ‐ Analysis

View Article: PubMed Central - PubMed

ABSTRACT

Background: Early age (<45 years) at menopause has been postulated to be associated with increased cardiovascular disease risk; however, evidence of its relation with heart failure (HF) incidence is limited. We examined whether age at menopause is associated inversely with HF incidence in the Atherosclerosis Risk In Communities (ARIC) study and summarized all existing data in a meta‐analysis.

Methods and results: In ARIC, data were obtained from 5629 postmenopausal women (mean age 56 years, 26% with bilateral oophorectomy) without HF. During a median follow‐up of 21.4 years, 965 incident HF events occurred. In a Cox regression model adjusted for reproductive health and HF risk factors, the hazard ratios for incident HF across categories of age at menopause (<45, 45–49, 50–54, and ≥55 years) were 1.32, 1.17, 1.00 (referent), and 1.12, respectively. Compared with women with later onset of menopause (aged ≥45 years), those with early menopause had elevated HF risk (hazard ratio 1.20, 95% CI 1.01–1.43). For the meta‐analysis, we searched Medline and Embase for articles published through December 2015 that prospectively evaluated age at menopause and HF risk. Summarized estimates from the 3 included studies (3568 events) showed higher HF risk among women with early menopause compared with those with later menopause (hazard ratio 1.33, 95% CI 1.15–1.53).

Conclusions: These results provided evidence that early age at menopause is associated with a modestly greater risk of HF. Identification of women with early menopause offers a window of opportunity to implement interventions that will improve overall cardiovascular health during the postmenopausal years.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier cumulative incidence estimates of HF according to age at menopause, ARIC, 1987 to 2012. Log‐rank test P=0.001. ARIC indicates Atherosclerosis Risk In Communities; HF, heart failure.
© Copyright Policy - creativeCommonsBy-nc
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5015298&req=5

jah31669-fig-0002: Kaplan–Meier cumulative incidence estimates of HF according to age at menopause, ARIC, 1987 to 2012. Log‐rank test P=0.001. ARIC indicates Atherosclerosis Risk In Communities; HF, heart failure.

Mentions: During a median follow‐up of 21.4 years, 965 incident HF events and 755 CHD events occurred. The incidence of HF according to age at menopause of <45, 45 to 49, 50 to 54, and ≥55 years was 10.7, 8.5, 7.3, and 10.7 events per 1000 person‐years, respectively (Table 2); corresponding estimates for CHD were 15.5, 13.8, 11.1, and 13.3 events per 1000 person‐years, respectively. In Kaplan–Meier cumulative incidence analysis, a younger age at menopause was significantly associated with higher incidence of HF (Figure 2). Compared with women who reached menopause at age 50 to 54 years, the HRs for incident HF were 1.38, 1.16, and 1.08 for women who reached menopause at age <45, 45 to 49, and ≥55 years, respectively (Table 2). Additional adjustment for reproductive health factors and interim CHD did not significantly alter the observed associations with the HRs for incident HF, observed to be 1.32, 1.17, and 1.12 for women who reached menopause at age <45, 45 to 49, and ≥55 years, respectively, compared with women who reached menopause at age 50 to 54 years. A 1‐year increment in age at menopause was not significantly inversely associated with the incidence of HF (HR 0.99, 95% CI 0.98–1.00, P=0.16). No statistically significant (P>0.05) 2‐way interactions of age at menopause with race, smoking status, BMI, waist circumference, systolic blood pressure, diabetes mellitus, hormone therapy use, or type of menopause were identified.


Association of Age at Menopause With Incident Heart Failure: A Prospective Cohort Study and Meta ‐ Analysis
Kaplan–Meier cumulative incidence estimates of HF according to age at menopause, ARIC, 1987 to 2012. Log‐rank test P=0.001. ARIC indicates Atherosclerosis Risk In Communities; HF, heart failure.
© Copyright Policy - creativeCommonsBy-nc
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5015298&req=5

jah31669-fig-0002: Kaplan–Meier cumulative incidence estimates of HF according to age at menopause, ARIC, 1987 to 2012. Log‐rank test P=0.001. ARIC indicates Atherosclerosis Risk In Communities; HF, heart failure.
Mentions: During a median follow‐up of 21.4 years, 965 incident HF events and 755 CHD events occurred. The incidence of HF according to age at menopause of <45, 45 to 49, 50 to 54, and ≥55 years was 10.7, 8.5, 7.3, and 10.7 events per 1000 person‐years, respectively (Table 2); corresponding estimates for CHD were 15.5, 13.8, 11.1, and 13.3 events per 1000 person‐years, respectively. In Kaplan–Meier cumulative incidence analysis, a younger age at menopause was significantly associated with higher incidence of HF (Figure 2). Compared with women who reached menopause at age 50 to 54 years, the HRs for incident HF were 1.38, 1.16, and 1.08 for women who reached menopause at age <45, 45 to 49, and ≥55 years, respectively (Table 2). Additional adjustment for reproductive health factors and interim CHD did not significantly alter the observed associations with the HRs for incident HF, observed to be 1.32, 1.17, and 1.12 for women who reached menopause at age <45, 45 to 49, and ≥55 years, respectively, compared with women who reached menopause at age 50 to 54 years. A 1‐year increment in age at menopause was not significantly inversely associated with the incidence of HF (HR 0.99, 95% CI 0.98–1.00, P=0.16). No statistically significant (P>0.05) 2‐way interactions of age at menopause with race, smoking status, BMI, waist circumference, systolic blood pressure, diabetes mellitus, hormone therapy use, or type of menopause were identified.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Early age (&lt;45&nbsp;years) at menopause has been postulated to be associated with increased cardiovascular disease risk; however, evidence of its relation with heart failure (HF) incidence is limited. We examined whether age at menopause is associated inversely with HF incidence in the Atherosclerosis Risk In Communities (ARIC) study and summarized all existing data in a meta&#8208;analysis.

Methods and results: In ARIC, data were obtained from 5629 postmenopausal women (mean age 56&nbsp;years, 26% with bilateral oophorectomy) without HF. During a median follow&#8208;up of 21.4&nbsp;years, 965 incident HF events occurred. In a Cox regression model adjusted for reproductive health and HF risk factors, the hazard ratios for incident HF across categories of age at menopause (&lt;45, 45&ndash;49, 50&ndash;54, and &ge;55&nbsp;years) were 1.32, 1.17, 1.00 (referent), and 1.12, respectively. Compared with women with later onset of menopause (aged &ge;45&nbsp;years), those with early menopause had elevated HF risk (hazard ratio 1.20, 95% CI 1.01&ndash;1.43). For the meta&#8208;analysis, we searched Medline and Embase for articles published through December 2015 that prospectively evaluated age at menopause and HF risk. Summarized estimates from the 3 included studies (3568 events) showed higher HF risk among women with early menopause compared with those with later menopause (hazard ratio 1.33, 95% CI 1.15&ndash;1.53).

Conclusions: These results provided evidence that early age at menopause is associated with a modestly greater risk of HF. Identification of women with early menopause offers a window of opportunity to implement interventions that will improve overall cardiovascular health during the postmenopausal years.

No MeSH data available.


Related in: MedlinePlus