Early Menopause Increases Heart Risks

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Early menopause, before age 40, may increase the risk for cardiovascular disease.

Using a British health database, researchers studied records of 144,260 postmenopausal women, average age around 60. Among them, 4,904, or 3.4 percent, had reached menopause before 40 naturally; 644 had gone into early menopause because they had oophorectomies, or surgical removal of the ovaries. The study is in JAMA.

During an average follow-up of seven years, 6 percent of women who reached menopause naturally before 40 developed cardiovascular disease, as did 7.6 percent of women who had oophorectomies before 40. But during the study period, only 3.9 percent of those who reached menopause after 40 did so.

While premature menopause significantly increased the risk for coronary artery disease, heart failure, blood clots and heart valve problems, researchers found no increased risk for stroke or peripheral artery disease.

Over all, compared with women who reached menopause after 40, those who reached menopause earlier either naturally or by surgery were at significantly increased risk for a first cardiovascular disease diagnosis.

“Doctors don’t ask about menopause history in cardiovascular risk assessment,” said the senior author, Dr. Pradeep Natarajan, an assistant professor of medicine at Harvard. “So we’re missing an opportunity. We hope that greater awareness will help address this, and that clinicians will incorporate natural and surgical menopausal age in their risk discussions and risk reduction plans.”