Early and surgical menopause associated with higher Framingham Risk Scores for cardiovascular disease in the Canadian Longitudinal Study on Aging

Price, Madison; Alvarado, Beatriz; Rosendaal, Nicole; Câmara, Saionara Maria Aires da; Pirkle, Catherine M; Vélez, Maria P.

doi:10.1097/gme.0000000000001729

Cited by 24 publications

(15 citation statements)

References 21 publications

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“…In our study, both early and late menopausal ages were associated with higher FRS, and the associations varied by parity. Our results were generally consistent with a cross-sectional study of the Canadian Longitudinal Study on Aging, which showed that early menopause was associated with higher FRS 31 . Other previous studies 8-11 also showed that early menopausal age was associated with higher risk of CVD, whilst late menopause was associated with a higher risk of hemorrhagic stroke in a prospective study of the Korean Elderly Pharmacoepidemiologic Cohort 12 .…”

Section: Discussionsupporting

confidence: 91%

“…Our results were generally consistent with a cross-sectional study of the Canadian Longitudinal Study on Aging, which showed that early menopause was associated with higher FRS. 31 Other previous studies [8][9][10][11] also showed that early menopausal age was associated with higher risk of CVD, whilst late menopause was associated with a higher risk of hemorrhagic stroke in a prospective study of the Korean Elderly Pharmacoepidemiologic Cohort. 12 In our study, women with later menopausal age had higher prevalence of diabetes and hypertension, and were therefore more prone to develop CVD.…”

Section: Discussionmentioning

confidence: 84%

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Natural menopausal age and cardiovascular disease risk factors in older Chinese women: Guangzhou Biobank Cohort Study

et al. 2021

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Objective: To examine the associations of natural menopausal age with cardiovascular disease risk factors and whether the associations varied by parity in older Chinese women. Methods: Information of demographic characteristics, lifestyles, and reproductive factors was collected by face-to-face interview. Framingham Risk Score was used as an indicator of cardiovascular disease risk, with a score ≥ 10% considered as high cardiovascular disease risk (vs low, dichotomous). Multivariable logistic and linear regressions were used to examine the associations of menopausal age with cardiovascular disease risk factors. Results: Of 18,339 women aged 50+ years, the average (standard deviation) age was 61.8 (6.9) years. Compared with women with menopausal age of 45 to 54 years, after adjustment for multiple potential confounders, women with menopausal age <45 years or ≥55 years had higher Framingham Risk Score (0.93%, 95% confidence interval: 0.40-1.46, and 0.69%, 95% confidence interval: 0.18-1.20, respectively). Women with menopausal age <45 or ≥55 years had higher odds of high cardiovascular disease risk (vs low) (odds ratio [95% confidence interval]:1.26 (1.10-1.44) and 1.17 (1.02-1.33), respectively). The associations of menopausal age with the Framingham Risk Score varied by parity (P for interaction ≤0.001). The Framingham Risk Score was higher in those with one to three parity (<45 y: 1.01 [0.43-1.59]; ≥55 y: 1.14 [0.60-1.68]) and lower for parity ≥4 (<45 y: −0.33 [−1.84 to 1.18]; ≥55 y: −2.02 [−3.82 to −0.22]). In nulliparous women, the Framingham Risk Score was highest in menopausal age <45 years (3.97 [1.67-6.26]), but the differences were nonsignificant in menopausal age ≥55 years (0.66 [−1.38 to 2.71]). Conclusions: Both early and late natural menopausal ages were associated with a higher cardiovascular disease risk, and the associations were stronger in those with lower parity. Video Summary: http://links.lww.com/MENO/A813.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 84%

Natural menopausal age and cardiovascular disease risk factors in older Chinese women: Guangzhou Biobank Cohort Study

et al. 2021

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“…3,[32][33][34] Given the role of surgical management in endometriosis, it was not surprising that, in our population, more patients with endometriosis had hysterectomies, oophorectomies and pre mature ovarian insufficiency than those in the unexposed group. As previously shown in the Women's Health Initiative cohort, 35 and the Canadian Longitudinal Study on Aging (CLSA), 36 females who eventually undergo a hysterectomy have been shown to have a worse cardiovascular risk profile and higher incidence of CVD. This supports other studies that suggested hysterectomy and oophorectomy among younger females with endometriosis may increase the risk of coronary heart disease.…”

Section: Discussionmentioning

confidence: 73%

Endometriosis and cardiovascular disease: a population-based cohort study

Blom¹,

Vélez²,

McClintock³

et al. 2023

cmajo

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Background: Endometriosis, a prevalent condition among females of reproductive age, may be associated with increased risk of cardiovascular disease (CVD) through chronic inflammation and early menopause. The objective of this study was to estimate the association between endometriosis and subsequent risk of CVD. Methods:We conducted a population-based cohort study using administrative health data from Ontario residents from 1993 to 2015. We compared the incidence of CVD and cardiovascular health outcomes between females with endometriosis and 2 age-matched females without endometriosis. The primary outcome was hospital admission for CVD. Secondary outcomes included in-hospital CVD events of interest and emergency department visits for CVD. We used Cox proportional hazards models to estimate adjusted hazard ratios (HRs) between endometriosis and CVD events. Results:We identified 166 835 eligible patients with endometriosis and matched 333 706 patients without endometriosis. The mean age of those with endometriosis was 36.4 years. Patients with endometriosis had a higher incidence of hospital admission for CVD (195 admissions/100 000 person-years) compared with those without endometriosis (163 admissions/100 000 person-years). Similarly, the incidence of secondary CVD events was slightly higher among patients with endometriosis (292 cases/100 000 personyears) than among those without endometriosis (224 cases/100 000 person-years). Females with endometriosis had an increased risk of hospital admission (adjusted HR 1.14, 95% confidence interval [CI] 1.10-1.19) and secondary CVD events (adjusted HR 1.26, 95% CI 1.23-1.30).Interpretation: In this large, population-based study, endometriosis was associated with a small increased risk of CVD events. Future studies need to investigate potential etiological mechanisms and strategies to decrease long-term CVD risk in patients with endometriosis.

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“…Evidence that estrogen/s may be protective comes from our finding that women with cardiomyopathy and early menopause had higher sST2 levels ( Figure 5 ) indicating that estrogen may reduce sST2 levels. A recent study found that women with early or surgical menopause had higher Framingham Risk Scores for CVD than those with normal menopause ( 48 ). But other factors may contribute to age-related changes in sST2 in men and women such as shifts over time in mitochondrial function, which has been associated with HF ( 49 ).…”

Section: Discussionmentioning

confidence: 99%

Sex and age differences in sST2 in cardiovascular disease

Beetler

Bruno

Florio

et al. 2023

Front. Cardiovasc. Med.

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AimsThe goal of this study was to determine whether sex and age differences exist for soluble ST2 (sST2) for several cardiovascular diseases (CVDs).MethodsWe examined sST2 levels using an ELISA kit for myocarditis (n = 303), cardiomyopathy (n = 293), coronary artery disease (CAD) (n = 239), myocardial infarct (MI) (n = 159), and congestive heart failure (CHF) (n = 286) and compared them to controls that did not have CVDs (n = 234).ResultsMyocarditis occurred in this study in relatively young patients around age 40 while the other CVDs occurred more often in older individuals around age 60. We observed a sex difference in sST2 by age only in myocarditis patients (men aged 38, women 46, p = 0.0002), but not for other CVDs. Sera sST2 levels were significantly elevated compared to age-matched controls for all CVDs: myocarditis (p ≤ 0.0001), cardiomyopathy (p = 0.0009), CAD (p = 0.03), MI (p = 0.034), and CHF (p < 0.0001) driven by elevated sST2 levels in females for all CVDs except myocarditis, which was elevated in both females (p = 0.002) and males (p ≤ 0.0001). Sex differences in sST2 levels were found for myocarditis and cardiomyopathy but no other CVDs and were higher in males (myocarditis p = 0.0035; cardiomyopathy p = 0.0047). sST2 levels were higher in women with myocarditis over 50 years of age compared to men (p = 0.0004) or women under 50 years of age (p = 0.015). In cardiomyopathy and MI patients, men over 50 had significantly higher levels of sST2 than women (p = 0.012 and p = 0.043, respectively) but sex and age differences were not detected in other CVDs. However, women with cardiomyopathy that experienced early menopause had higher sST2 levels than those who underwent menopause at a natural age range (p = 0.02).ConclusionWe found that sex and age differences in sera sST2 exist for myocarditis, cardiomyopathy, and MI, but were not observed in other CVDs including CAD and CHF. These initial findings in patients with self-reported CVDs indicate that more research is needed into sex and age differences in sST2 levels in individual CVDs.

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Early and surgical menopause associated with higher Framingham Risk Scores for cardiovascular disease in the Canadian Longitudinal Study on Aging

Cited by 24 publications

References 21 publications

Natural menopausal age and cardiovascular disease risk factors in older Chinese women: Guangzhou Biobank Cohort Study

Natural menopausal age and cardiovascular disease risk factors in older Chinese women: Guangzhou Biobank Cohort Study

Endometriosis and cardiovascular disease: a population-based cohort study

Sex and age differences in sST2 in cardiovascular disease

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