RT Journal Article
SR Electronic
T1 Age of menopause, healthy lifestyle and cardiovascular disease in women: a prospective cohort study
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 262
OP 268
DO 10.1136/heartjnl-2024-324602
VO 111
IS 6
A1 Pant, Anushriya
A1 Gibson, Alice A
A1 Marschner, Simone
A1 Liao, Lee P
A1 Laranjo, Liliana
A1 Chow, Clara K
A1 Zaman, Sarah
YR 2025
UL http://heart.bmj.com/content/111/6/262.abstract
AB Background Menopause is a timely opportunity to screen for cardiovascular disease (CVD) and intervene with healthier lifestyles. We investigated the association between premature/early menopause and the likelihood of CVD and whether a healthy lifestyle is associated with a lower likelihood of CVD in menopausal woman.Methods The Sax Institute’s 45 and Up Study prospectively recruited participants aged ≥45 years (n=267 357) between 2005 and 2009 (New South Wales, Australia). Our study included women without prior CVD and reporting menopausal age at baseline. Primary outcome was new-onset CVD (self-reported heart disease/stroke) based on survey data at Wave 2 (2012–2015) and/or Wave 3 (2018–2020). Logistic regression models assessed the associations of premature (age <40 years) and early (age 40–44 years) menopause with CVD, compared with menopause between 50 and 52 years, adjusting for sociodemographic and clinical variables. Healthy lifestyle adherence was assessed using a score of five factors: smoking, physical activity, sitting, sleep and diet.Results We included 46 238 women (mean age 62.1±8.2 years), with 5416 (11.7%) cases of CVD over 15-year follow-up. After adjustment, the odds of CVD was higher in women with premature menopause (OR 1.36, 95% CIs 1.17 to 1.59; p<0.0001) and early menopause (OR 1.15, 95% CI 1.03 to 1.28; p=0.013) compared with menopause between 50 and 52 years. Among all women, high (score 9–10) versus low (score 0–5) healthy lifestyle adherence led to 23% lower odds of CVD (OR 0.77, 95% CI 0.68 to 0.86; p<0.0001), and in women with premature menopause, led to 52% lower odds of CVD (OR 0.48, 95% CI 0.30 to 0.77, p=0.0022). Lifestyle effect did not significantly differ between menopause categories (interaction, p=0.71).Conclusion Women with premature/early menopause are at higher likelihood for CVD. Lifestyle modification is associated with consistent reduction of the likelihood of CVD in women and should be encouraged across the life course.No data are available. The data for this study will not be shared, as we do not have permission from the participants or ethics approval to do so.