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. 2012 Oct;19(10):1081-7.
doi: 10.1097/gme.0b013e3182517bd0.

Early menopause predicts future coronary heart disease and stroke: the Multi-Ethnic Study of Atherosclerosis

Melissa Wellons  1 , Pamela Ouyang, Pamela J Schreiner, David M Herrington, Dhananjay Vaidya
Affiliations

Early menopause predicts future coronary heart disease and stroke: the Multi-Ethnic Study of Atherosclerosis

Melissa Wellons et al. Menopause. 2012 Oct.

Abstract

Objective: Cardiovascular disease is the number one killer of women. Identifying women at risk of cardiovascular disease has tremendous public health importance. Early menopause is associated with increased cardiovascular disease events in some predominantly white populations, but not consistently. Our objective was to determine if self-reported early menopause (menopause at an age <46 y) identifies women as at risk for future coronary heart disease or stroke.

Methods: The study population came from the Multi-Ethnic Study of Atherosclerosis, a longitudinal, ethnically diverse cohort study of US men and women aged 45 to 84 years enrolled in 2000-2002 and followed up until 2008. The association between a personal history of early menopause (either natural menopause or surgical removal of ovaries at an age <46 y) and future coronary heart disease and stroke was assessed in 2,509 women (ages 45-84 y; 987 white, 331 Chinese, 641 black, and 550 Hispanic) from the Multi-ethnic Study Atherosclerosis who were free of cardiovascular disease at baseline.

Results: Of 2,509 women, 693 (28%) reported either surgical or natural early menopause. In survival curves, women with early menopause had worse coronary heart disease and stroke-free survival (log rank P = 0.008 and P = 0.0158). In models adjusted for age, race/ethnicity, Multi-ethnic Study Atherosclerosis site, and traditional cardiovascular disease risk factors, this risk for coronary heart disease and stroke remained (hazard ratio, 2.08; 95% CI, 1.17-3.70; and hazard ratio, 2.19; 95% CI, 1.11-4.32, respectively).

Conclusions: Early menopause is positively associated with coronary heart disease and stroke in a multiethnic cohort, independent of traditional cardiovascular disease risk factors.

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Conflict of interest statement

Financial disclosures/conflicts of interest: None reported.

Figures

Figure 1
Figure 1
Flow of MESA Sample Selection of Women with and without Early Menopause.
Figure 2
Figure 2
Kaplan Meier Survival Curves for Coronary Heart Disease in Women with and without Early Menopause.
Figure 3
Figure 3
Kaplan Meier Survival Curves for Stroke in Women with and without Early Menopause.
See this image and copyright information in PMC

Comment in

  • Cardiovascular risk and early menopause: cause or consequence?
    Stuenkel CA. Stuenkel CA. Menopause. 2012 Oct;19(10):1067-9. doi: 10.1097/gme.0b013e31826883f6. Menopause. 2012. PMID: 23014137 No abstract available.
  • Letters to the editor.
    Hayes VW, Depalma RG, Zacharski LR. Hayes VW, et al. Menopause. 2013 Mar;20(3):361-2. doi: 10.1097/GME.0b013e318287b888. Menopause. 2013. PMID: 23435037 No abstract available.
  • Letters to the editor.
    Wellons M, Vaidya D. Wellons M, et al. Menopause. 2013 Mar;20(3):362. doi: 10.1097/GME.0b013e3182893459. Menopause. 2013. PMID: 23435038 No abstract available.

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