Age at Menarche and Risks of Coronary Heart and Other Vascular Diseases in a Large UK Cohort

Abstract

Background-Early menarche has been associated with increased risk of coronary heart disease (CHD), but most studies were relatively small and could not assess risk across a wide range of menarcheal ages; few have examined associations with other vascular diseases. We examined CHD, cerebrovascular disease, and hypertensive disease risks by age at menarche in a large prospective study of UK women. Methods and Results-In 1.2 million women (mean±SD age, 56±5 years) without previous heart disease, stroke, or cancer, menarcheal age was reported to be 13 years by 25%, ≤10 years by 4%, and ≥17 years by 1%. After 11.6 years of follow-up, 73 378 women had first hospitalization for or death from CHD, 25 426 from cerebrovascular disease, and 249 426 from hypertensive disease. Using Cox regression, we calculated relative risks for each vascular outcome by single year of menarcheal age. The relationship was U-shaped for CHD. Compared with women with menarche at 13 years, the adjusted relative risk for CHD for menarche at ≤10 years of age was 1.27 (95% confidence interval, 1.22-1.31; P<0.0001) and for menarche at ≥17 years of age was 1.23 (95% confidence interval, 1.16-1.30; P<0.0001). U-shaped relationships were also seen for cerebrovascular and hypertensive disease, although the magnitudes of these risks for early and late menarche were smaller than those for CHD. Conclusions-In this cohort, the relation of age at menarche to vascular disease risk was U shaped, with both early and late menarche being associated with increased risk. Associations were weaker for cerebrovascular and hypertensive disease than for CHD.

Age at Menarche and Cardiometabolic Health: A Sibling Analysis in the Scottish Family Health Study

“…The reference group in all analyses comprised those with an age at menarche of 12 to 13 years. There is some variation across studies in the definition of early menarche (≤10, ≤11, or ≤12 years) and late menarche (≥14, ≥15, or ≥16 years), likely influenced by the size and information available in the specific study, but our categorization is in line with commonly used cutoff values 4, 5, 6, 7, 8, 10, 11, 14, 16…”

“…In line with these findings, there is some but less consistent evidence of an association between age at menarche and cardiovascular disease (CVD) events 12, 16, 17, 18. Mendelian randomization studies suggest causal effects of greater childhood BMI on early timing of menarche and of earlier menarche on higher adult BMI and CVD risk,19, 20 although genetic pleiotropy may at least partially explain these findings 12.…”

Impact of age at menarche on obesity and glycemic control in Japanese patients with type 2 diabetes: Fukuoka Diabetes Registry

“…In Japan, the mean age at menarche decreased from 13.2 years in 1961 to 12.2 years in 2011 in school‐aged girls1. Earlier‐onset menarche is reported to be associated with obesity2, 3, 4, 5, type 2 diabetes mellitus4, 6, 7, 8, 9, 10, 11, cardiovascular disease4, 12, 13, 14, breast cancer15 and increased all‐cause mortality4, 13, 16, 17, 18. It is therefore possible that age at menarche can provide important information to help prevent non‐communicable diseases.…”

Menstrual Factors and Stroke Incidence in Japanese Postmenopausal Women: The Ohasama Study

“…The association between early menarche and all-cause mortality is relatively consistent [6] . However, the association between early menarche and cardiovascular diseases, especially stroke, has not been well investigated [6][7][8] . It has been demonstrated that early menopause has a modest effect on cardiovascular diseases [9] .…”