Heart Disease Risk Determines Menopausal Age Rather Than the Reverse

Kok, Helen S.; Asselt, Kristel M. van; Schouw, Yvonne T. van der; Tweel, Ingeborg van der; Peeters, Petra H.M.; Wilson, Peter W.F.; Pearson, P. L.; Grobbee, Diederick E.

doi:10.1016/j.jacc.2005.12.066

Cited by 201 publications

(124 citation statements)

References 46 publications

(29 reference statements)

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“…22 It has been postulated that cardiovascular risk in women was related to interactions between cardiovascular risk factors and menopause, 23 to a stronger inverse association between coronary heart disease and HDL cholesterol level in women than in men, to differences in coagulation, to differences in patterns of obesity, and to a role for hyperinsulinemia. 22,24,25 The impact of cardiovascular factors such as diabetes on risk for cardiovascular disease and for death is reported to be greater in women than in men in the GP.…”

Section: Discussionmentioning

confidence: 99%

Effect of Age, Gender, and Diabetes on Excess Death in End-Stage Renal Failure

Villar

Remontet

Labeeuw

et al. 2007

Journal of the American Society of Nephrology

150

116

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Life expectancy is short in elderly individuals with end-stage renal failure (ESRF). This study aimed to compare mortality in patients with ESRF versus the general population (GP) to assess the evolution of excess mortality by age, gender, nephropathy, and dialysis modality after first dialysis. All incident adult dialysis patients from January 1,1999, to December 31, 2003, who lived in Rhô ne-Alpes Region (France) were included and followed up to death or December 31, 2005. Standardized mortality ratios (SMR) in comparison with GP were computed in the first to the fifth years after first dialysis. In the whole cohort (3025 incident patients), SMR decreased during these 5 yr from 7.4 to 5.2 (P ϭ 0.002). In the 18-to 44-, 45-to 64-, 65-to 74-, 75-to 84-, and Ն85-yr-old groups, SMR decreased from 26.7 to 6.2 (P ϭ 0.01), from 12.8 to 8.1 (P ϭ 0.03), from 8.6 to 5.6 (P ϭ 0.051), from 7.1 to 4.5 (P ϭ 0.02), and from 3.5 to 1.2 (P ϭ 0.14), respectively. Among age categories, differences were significant in the first 3 yr (P Ͻ 0.05). SMR were higher 1.5-fold in women than in men in the first 4 yr (P Ͻ 0.05). In patients with diabetic nephropathy (DN), SMR increased during the first 3 yr (P ϭ 0.045) and were higher than in patients without DN in the second, third, and fourth years (P Ͻ 0.05). SMR were higher in the peritoneal dialysis than in the hemodialysis group in the fourth year (P Ͻ 0.01). Patients with ESRF have a high excess mortality compared with the GP. Older patients with ESRF experienced less excess mortality. ESRF cancels out women's survival advantage noted in the GP. SMR evolution in patients with DN was different from that in patients without DN.

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Section: Discussionmentioning

confidence: 99%

Effect of Age, Gender, and Diabetes on Excess Death in End-Stage Renal Failure

Villar

Remontet

Labeeuw

et al. 2007

Journal of the American Society of Nephrology

150

116

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“…Other studies support the hypothesis that the reduction of estrogen would be the main factor for the increase of this incidence, directly associated with aging and biological aging, which itself already contributes to the increase of health problems. However, Kok et al (2006) [30] conducted a study with Framingham's data to investigate whether cardiovascular risk profile could accelerate menopause. The results showed that the risk of heart disease determines the age of menopause.…”

Section: Discussionmentioning

confidence: 99%

Menopausal Status and Metabolic Syndrome in Women in Climacteric Period Treated at a Clinic in Southern Brazil

Mendes¹,

Theodoro²,

Rodrigues³

et al. 2013

OJEMD

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Background: This study aims to understand the relationship between menopausal status and the presence of Metabolic Syndrome in women from 40 to 65 years, as well as to describe the distribution of each component of Metabolic Syndrome according to sample characteristics. Methods: A cross-sectional study was conducted with 551 women treated at a clinic in southern Brazil. MetS and its components were defined according to NCEP-ATP III and menopausal status as pre, peri, and post-menopause. Prevalences of menopausal status and of MetS and its components were calculated. Estimates of prevalence ratios crude and adjusted with confidence intervals of 95% were calculated by Poisson Regression with robust variance. Demographic, socioeconomic, behavioral, and reproductive characteristics were considered as potential confounding factors in multivariable models based on a conceptual framework of MetS determination. Results: The prevalence of Metabolic Syndrome in the sample was 56.1% (CI 95% : 51.9 to 60.2), being more common among older women (56 to 65 years), with low education, menarche <11 years old, with three or more pregnancies and in the post-menopausal period. In multivariate analysis, there was an increase of prevalence ratios when comparing perimenopause and post-menopause with pre-menopause; however, the confidence intervals include the unit. Regarding the analysis of isolated components in the sample, the most prevalent altered components were: hypertension (84.8%; CI 95% : 81.7 to 87.8), waist circumference (66.4%; CI 95% : 62.5 to 70.4) and HDL cholesterol (51.7%; CI 95% : 47.5 to 55.9). There was a linear increase on mean blood glucose through menopausal status. Conclusions: Our study indicates variation on the distribution of MetS and each component according to menopausal status and other women characteristics. Future studies on MetS should also have foresight to use this type of approach to improve understanding and targeting of actions and programs focusing on women in this period of life.

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“…Consequently, POI is potentially associated with both more severe and different health risks than natural menopause. Women entering menopause early seem to be at increased risk of cardiovascular disease (6). In addition, impaired endothelial dysfunction, an early stage of atherosclerosis, has been described in young women with POI (7).…”

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confidence: 99%