Irregularidade do ciclo menstrual no menacme como marcador para fatores de risco cardiovasculares na pós-menopausa

Azevedo, George Dantas de; Duarte, João-Marcelo B.P.; Souza, M. O.; Costa-e-Silva, Thiago D.N.; Soares, Elvira Maria Mafaldo; Maranhão, Técia Maria de Oliveira

doi:10.1590/s0004-27302006000500008

Cited by 18 publications

(5 citation statements)

References 27 publications

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“…There have been conflicting results from studies investigating the association between menstrual cycle characteristics and hypertension. Irregular menstrual cycles and oligomenorrhea have been reported to be potential markers of CVD risk, including coronary heart disease, in a cohort study of European women, and were also associated with arterial hypertension in a retrospective case-control study of 414 postmenopausal Brazilian women [25, 26]. Longer menstrual cycle length has also been reported to be associated with CVD risk factors such as blood lipid levels and DBP [27].…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, our study contains several strengths. Firstly, our study has a large sample size and extensive data on menstrual characteristics [26], which we leveraged to comprehensively analyze the relationship between menstrual characteristics and hypertension. Secondly, the age range of our participants was narrow, and the relatively young age of the participants meant we were able to avoid the instability of menstrual characteristics during pre-menopause.…”

Section: Discussionmentioning

confidence: 99%

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Obesity as an effect modifier of the association between menstrual abnormalities and hypertension in young adult women: Results from Project ELEFANT

Barrow

et al. 2018

PLoS ONE

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BackgroundThe menstrual cycle is regulated by reproductive hormones such as estrogen which has been implicated in the pathogenesis of hypertension and is associated with obesity. However, to date there has scant study of hypertension in relation to menstrual characteristics and abnormalities. We hypothesize that adverse menstrual characteristics are associated with an increase the prevalence of hypertension and that this relationship is exacerbated by obesity.MethodsOur study leverages 178,205 healthy female participants (mean age = 29) in a population-based cross-sectional study in Tianjin, China. Menstrual characteristics including menstrual cycle length and regularity, menstrual bleeding length, menstrual blood loss and dysmenorrhea were assessed by self-reported questionnaires, and hypertension was diagnosed by physician. Multiple logistic regression models were used to assess the relationships between menstrual characteristics and hypertension.ResultsNormal length menstrual cycle (OR = 1.21, 95% CI: 1.03–1.41), oligomenorrhea (OR = 1.54, 95% CI: 1.12–2.07), irregular cycle (OR = 1.54, 95% CI: 1.22–1.93), and light menstrual blood loss (OR = 1.36, 95% CI: 1.06–1.72) were associated with hypertension among women who are overweight or obese, but not among women who are normal weight. Longer menstrual bleeding duration (OR = 1.44, 95% CI: 1.24–1.67) and dysmenorrhea were associated with increased prevalence of hypertension (OR = 1.20, 95% CI: 1.14–1.41) in all young women.ConclusionsThe prevalence of hypertension is higher among women with menstrual abnormalities, and this association is modified by overweight and obesity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Obesity as an effect modifier of the association between menstrual abnormalities and hypertension in young adult women: Results from Project ELEFANT

Barrow

et al. 2018

PLoS ONE

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“…4,[7][8][9] However, the associations of irregular and long cycles at different points throughout a woman's reproductive lifespan with CVD remain unclear. Furthermore, while growing evidence shows that irregular and long cycles are associated with a higher risk of conditions that are well-established CVD risk factors, such as hypercholesterolemia, 10 chronic hypertension, 10 and type 2 diabetes, 11 limited data are available to inform the extent to which these may mediate the associations between cycle characteristics and CVD risk.…”

Section: Introductionmentioning

confidence: 99%

“…JAMA Network Open. 2022;5(10):e2238513. doi:10.1001/jamanetworkopen.2022.38513 (Reprinted) October 25, 2022 12/13…”

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confidence: 99%

Menstrual Cycle Regularity and Length Across the Reproductive Lifespan and Risk of Cardiovascular Disease

et al. 2022

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ImportanceMenstrual cycle characteristics may be associated with an increased risk of cardiovascular disease (CVD). However, existing studies are limited, and few have explored the mediating role of established CVD risk factors.ObjectiveTo explore the associations of menstrual cycle characteristics across the reproductive lifespan with the risk of CVD and to what extent these associations were mediated by hypercholesterolemia, chronic hypertension, and type 2 diabetes.Design, Setting, and ParticipantsThis cohort study prospectively followed Nurses’ Health Study II participants between 1993 and 2017 who reported menstrual cycle regularity and length for ages 14 to 17 years and 18 to 22 years at enrollment in 1989 and updated current cycle characteristics in 1993 (at ages 29 to 46 years). Data analysis was performed from October 1, 2019, to January 1, 2022.ExposuresMenstrual cycle regularity and length across the reproductive lifespan.Main Outcomes and MeasuresIncident CVD events of interest, including fatal and nonfatal coronary heart disease (CHD; myocardial infarction [MI] or coronary revascularization) and stroke.ResultsA total of 80 630 Nurses’ Health Study II participants were included in the analysis, with a mean (SD) age of 37.7 (4.6) years and body mass index of 25.1 (5.6) at baseline. Over 24 years of prospective follow-up, 1816 women developed their first CVD event. Multivariable Cox proportional hazards models showed that, compared with women reporting very regular cycles at the same ages, women who had irregular cycles or no periods at ages 14 to 17, 18 to 22, or 29 to 46 years had hazard ratios for CVD of 1.15 (95% CI, 0.99-1.34), 1.36 (95% CI, 1.06-1.75), and 1.40 (95% CI, 1.14-1.71), respectively. Similarly, compared with women reporting a cycle length of 26 to 31 days, women reporting a cycle length 40 days or more or a cycle too irregular to estimate from ages 18 to 22 or 29 to 46 years had hazard ratios for CVD of 1.44 (95% CI, 1.13-1.84) and 1.30 (95% CI, 1.09-1.57), respectively. Mediation analyses showed that subsequent development of hypercholesteremia, chronic hypertension, and type 2 diabetes only explained 5.4% to 13.5% of the observed associations.Conclusions and RelevanceIn this cohort study, both irregular and long menstrual cycles were associated with increased rates of CVD, which persisted even after accounting for subsequently established CVD risk factors.

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“…When menstrual cycles are stable, a typical menstrual period will last for 3 to 5 days, while the average menstrual cycle will last for 28 days (range 21–35 days) [ 11 ]. Long or irregular menstrual cycles are associated with cardiovascular risk factors including hyperinsulinemia and dyslipidemia, hypertension, and diabetes mellitus [ 12 , 13 ]. The American College of Obstetricians and Gynaecologists recommends the inclusion of menstrual cycle history as a vital sign to improve the timely identification of potential adverse health outcomes in later life [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

The association between menstrual cycle characteristics and cardiometabolic outcomes in later life: a retrospective matched cohort study of 704,743 women from the UK

Okoth

Smith

Thomas

et al. 2023

BMC Med

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Background Female reproductive factors are gaining prominence as factors that enhance cardiovascular disease (CVD) risk; nonetheless, menstrual cycle characteristics are under-recognized as a factor associated with CVD. Additionally, there is limited data from the UK pertaining to menstrual cycle characteristics and CVD risk. Methods A UK retrospective cohort study (1995–2021) using data from a nationwide database (The Health Improvement Network). Women aged 18–40 years at index date were included. 252,325 women with history of abnormal menstruation were matched with up to two controls. Two exposures were examined: regularity and frequency of menstrual cycles; participants were assigned accordingly to one of two separate cohorts. The primary outcome was composite cardiovascular disease (CVD). Secondary outcomes were ischemic heart disease (IHD), cerebrovascular disease, heart failure (HF), hypertension, and type 2 diabetes mellitus (T2DM). Cox proportional hazards regression models were used to derive adjusted hazard ratios (aHR) of cardiometabolic outcomes in women in the exposed groups compared matched controls. Results During 26 years of follow-up, 20,605 cardiometabolic events occurred in 704,743 patients. Compared to women with regular menstrual cycles, the aHRs (95% CI) for cardiometabolic outcomes in women with irregular menstrual cycles were as follows: composite CVD 1.08 (95% CI 1.00–1.19), IHD 1.18 (1.01–1.37), cerebrovascular disease 1.04 (0.92–1.17), HF 1.30 (1.02–1.65), hypertension 1.07 (1.03–1.11), T2DM 1.37 (1.29–1.45). The aHR comparing frequent or infrequent menstrual cycles to menstrual cycles of normal frequency were as follows: composite CVD 1.24 (1.02–1.52), IHD 1.13 (0.81–1.57), cerebrovascular disease 1.43 (1.10–1.87), HF 0.99 (0.57–1.75), hypertension 1.31 (1.21–1.43), T2DM 1.74 (1.52–1.98). Conclusions History of either menstrual cycle irregularity or frequent or infrequent cycles were associated with an increased risk of cardiometabolic outcomes in later life. Menstrual history may be a useful tool in identifying women eligible for periodic assessment of their cardiometabolic health.

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Irregularidade do ciclo menstrual no menacme como marcador para fatores de risco cardiovasculares na pós-menopausa

Cited by 18 publications

References 27 publications

Obesity as an effect modifier of the association between menstrual abnormalities and hypertension in young adult women: Results from Project ELEFANT

Obesity as an effect modifier of the association between menstrual abnormalities and hypertension in young adult women: Results from Project ELEFANT

Menstrual Cycle Regularity and Length Across the Reproductive Lifespan and Risk of Cardiovascular Disease

The association between menstrual cycle characteristics and cardiometabolic outcomes in later life: a retrospective matched cohort study of 704,743 women from the UK

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