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Premature menopause may increase risk of heart failure: Study

DTMT Network

Attaining menopause earlier than forty years of age may increase the risk of heart problems including failures and arterial fibrillation (irregular heartbeat) among women, a new study has found.

The study, published in the journal of the European Society of Cardiology recently, analysed the health records of over 1.4 million women and found that the younger the age of menopause onset, the greater the risk of developing heart complications.

“Women with premature menopause should be aware that they may be more likely to develop heart failure or atrial fibrillation than their peers,” the author of the study, Dr Ga Eun Nam of Korea University College of Medicine, Seoul, said in a media release recently.

“This may be good motivation to improve lifestyle habits known to be linked with heart disease, such as quitting smoking and exercising,” she added.

Available data suggest that women develop cardiovascular diseases typically 10 years later than men due to what scientists believe are the protective effects of oestrogens on the cardiovascular system.

This study examined the associations between premature menopause, age at menopause, and incident heart failure and atrial fibrillation based on the data from Korean National Health Insurance System (NHIS), which provides health screening at least every two years and includes 97% of the population.

The researchers included 1,401,175 postmenopausal women aged 30 years and older who completed the NHIS health check-up in 2009 in their study and followed up with the participants until 2018, looking for new onset of heart failure and atrial fibrillation.

 They further categorised the age of onset of menopause as below 40, 40 to 44, 45 to 49, and 50 years or older, and defined premature menopause as those who had the final menstrual period before the age of 40 years.

 Analysis of the data revealed that some 28,111 or 2% of participants had a history of premature menopause and the average age of onset of menopause was found to be 36.7 years, the researchers noted in their paper.

 While the average age of enrollment for the study for those with a history of premature menopause was 60 years, the average age of those without any such history was 61.5 years.

 Over a period of 9.1 years of follow-up, while 42,699 (3.0%) developed heart failure, 44,834 (3.2%) developed atrial fibrillation, the researchers reported.

 Analysing the associations between age at menopause and incidence of heart failure and atrial fibrillation after adjusting for the same factors as in the previous analyses, the researchers reported that the risk of incident heart failure increased as the age at menopause decreased.

 Compared with women aged 50 years and above at menopause, those aged 45 to 49, 40 to 44, and below 40 years at menopause had 11%, 23%, and 39% greater risks of incident heart failure, respectively, the researchers said.

 Similarly, the researchers further found that the risk of arterial fibrillation increased as the age at menopause decreased, with 4%, 10%, and 11% higher risks for those aged 45 to 49, 40 to 44, and under 40 years at menopause, respectively, compared with women aged 50 years and above at menopause.

The authors said that several factors including a drop in the oestrogen level in the body and changes in body fat distribution, may explain the associations between menopausal age, heart failure and atrial fibrillation.

“The misconception that heart disease primarily affects men has meant that sex-specific risk factors have been mostly ignored. Evidence is accumulating that undergoing menopause before the age of 40 may increase the likelihood of heart disease later in life,” Dr Nam said.

“Our study indicates that reproductive history should be routinely considered in addition to traditional risk factors such as smoking when evaluating the future likelihood of heart failure and atrial fibrillation,” she added.

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