“Heart Health on the Horizon: How Early Menopause Can Shape Your Future”

Women who undergo premature (<40 years) or early menopause (40-44 years) face a greater risk of cardiovascular disease (CVD) compared to those whose menopause occurs between the ages of 50 and 52. Nevertheless, maintaining a healthy lifestyle, which includes quitting smoking, consistent physical activity, a nutritious diet, adequate sleep, and minimizing sedentary behavior, considerably decreases the chances of developing CVD, particularly for individuals with premature menopause.

“The menopausal period represents a vital opportunity to intervene and possibly lower a woman’s risk of CVD through lifestyle adjustments,” noted a group of researchers including Sarah Zaman, MBBS, Ph.D., an academic interventional cardiologist from Westmead Hospital and the University of Sydney, Australia. “This may encompass targeting crucial cardiometabolic changes pertinent to these women, especially those experiencing earlier menopause.”

Prior investigations have shown a correlation between earlier menopause and adverse cardiovascular outcomes, such as heart failure, coronary heart disease (CHD), and even mortality.

Researchers assessed the relationship between premature and early menopause and the likelihood of developing CVD, as well as whether a healthy lifestyle correlates with reduced odds of CVD utilizing subjects from The Sax Institute’s 45 and Up Study. These women had ages ranging from 45 years and older between 2005 and 2009 (Wave 1), were menopausal at the baseline, and had no history of CVD.

The primary outcome of the observational study was the occurrence of CVD, defined as self-reported heart disease, heart failure, or stroke, based on survey data from Wave 2 (2015-2015) and/or Wave 3 (2018-2020). Logistic regression models were employed to establish any connections between CVD and premature or early menopause, adjusted for clinical and sociodemographic factors. These elements included age, ethnicity, education level, body mass index (BMI), smoking status (current, former, or non-smoker), hypertension, diabetes mellitus, and the use of menopausal hormone therapy.

Adherence to a healthy lifestyle was evaluated using five components: smoking, sitting, sleep, diet, and physical activity.

A total of 46,238 women participated in the study, with an average age of 62.1 years. Over the 15-year follow-up period, 11.7% of women reported instances of CVD.

After adjusting for various factors, the risk of developing CVD was higher among women with premature menopause and early menopause compared to those who experienced menopause between 50 and 52 years. Despite this elevated risk, a high adherence score (9-10) to a healthy lifestyle resulted in a 23% lower chance of developing CVD when contrasted with those scoring low (0-5). Particularly for women experiencing premature menopause, a high score led to a 52% reduction in these odds. The lifestyle effect did not show significant differences across the three menopause categories.

Researchers suggested that forthcoming studies should concentrate on developing interventions aimed at fostering healthy lifestyles and evaluating their long-term impact on CVD.

The study was restricted by missing data and the observational nature, as unmeasured confounding variables could have influenced the results. Moreover, since the surveys relied on self-reporting and there were patients lost to follow-up over the 15-year duration, the proportion of lethal CVD cases could not be assessed. Furthermore, lifestyle behaviors were only recorded at baseline through self-reporting, notwithstanding the acknowledgment that these habits may vary over time, potentially affecting the risk of developing CVD.

“Menopause presents a timely chance to evaluate women, particularly those with early menopause, for cardiovascular well-being and advocate for healthy lifestyle initiatives throughout their lives,” the investigators concluded.