Abstract 12098: Reproductive Lifespan and Risk of Cardiovascular Disease (CVD) in Women
Background: Earlier age at menopause is associated with higher risk for cardiovascular disease, and hormonal changes are suspected to be involved. Earlier age at menarche is associated with higher risk of type 2 diabetes, but its association with CVD has been inconclusive. We investigated the association of the duration of reproductive lifespan, accounting for both age at menarche and menopause, with incident CVD.
Methods: We prospectively followed 83,169 Nurses’ Health Study participants without CVD at baseline, the year of reported menopause, through 2010. CVD was defined as coronary heart disease (CHD; nonfatal myocardial infarction or fatal) and stroke (nonfatal or fatal). The duration of reproductive lifespan was generated by subtracting age at menarche from age at menopause. The relative risks were estimated using Cox proportional hazard regression with adjustment for potential confounders.
Results: The median reproductive lifespan was 36 years (IQR 31-39). A shorter reproductive lifespan was associated with higher risk of incident CVD with multivariable adjustment for demographic, reproductive, and lifestyle factors, as well as prevalent and incident diabetes, hypertension, and hypercholesterolemia (RR 1.30 [95% CI 1.20-1.41] comparing duration <29 with ≥40 years; p-trend<0.0001; Table). A shorter reproductive lifespan was associated with higher risk of both CHD and stroke incidence individually after multivariable adjustment (both p-trend<0.0001). The association between reproductive lifespan and CVD remained significant when stratified by natural or surgically induced menopause (all p-trend≤0.03). Early age at menopause was associated with higher multivariable-adjusted CVD risk (1.33 [1.22-1.44] comparing age <40 with 50-<55 years; p-trend<0.0001), while earlier age at menarche was not significant after multivariable adjustment.
Conclusion: A shorter duration of reproductive lifespan is associated with higher risk of CVD.
Author Disclosures: S.H. Ley: None. Y. Li: None. D.K. Tobias: None. J.E. Manson: None. F.B. Hu: None. K.M. Rexrode: None.
- © 2014 by American Heart Association, Inc.