Population-based study of age at menopause and ultrasound assessed carotid atherosclerosis

Joakimsen, Oddmund; Bønaa, Kaare Harald; Stensland-Bugge, Eva; Jacobsen, Bjarne K.

doi:10.1016/s0895-4356(99)00197-3

Cited by 111 publications

(69 citation statements)

References 24 publications

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“…Furthermore, the lack of studies evaluating risk in relation to duration since menopause limited us from performing any meaningful quantitative synthesis using this exposure. Most studies that were identified adjusted for a range of relevant confounders, although one study was entirely unadjusted 23 , and three only adjusted for age [24][25][26] . Many studies did not examine the impact of important determinants of age at natural menopause, such as socioeconomic factors, number of births and lifestyle factors (smoking, alcohol intake and physical activity).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Association of Age at Onset of Menopause and Time Since Onset of Menopause With Cardiovascular Outcomes, Intermediate Vascular Traits, and All-Cause Mortality

et al. 2016

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Role of the Funder/Sponsor: Metagenics Inc. had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review or approval of the manuscript.The funder/sponsor did not have the ability to veto publication of study results. Data Extraction: Data were extracted by two independent reviewers using a pre-designed data collection form. Word count text: 3494 wordsMain outcomes and Measures: CVD outcomes (composite CVD, fatal and non-fatal coronary heart disease (CHD) and overall stroke and stroke mortality), CVD-mortality, all-cause mortality and intermediate CVD endpoints.Results: Out of initially identified references, 32 studies were selected, including 310,329 non-overlapping women. Women with a menopausal age of younger than 45 years compared to women with a menopausal age of 45 years or older, the relative risk (RR) [95% confidence intervals (CI)] was 1.50(1.28-1.76) for overall CHD, 1.11(1.03-1.20) for fatal CHD, 1.23 (0.98-1.53) for overall stroke, 0.99 (0.92-1.07) for stroke mortality, 1.19(1.08-1.31) for CVD mortality and 1.12(1.03-1.21) for all-cause mortality. For women with a menopausal age between 50-54 years compared to women with a menopausal age of younger than 50 years, there was a decreased risk of fatal CHD (RR:0.87(95%CI:0.80-0.96)), and no effect on stroke. Duration since menopause in relation to risk of developing intermediate cardiovascular traits or CVD outcomes was reported in 4 observational studies, reporting no consistent results. Conclusions and Relevance:The findings of this review indicate an excess CHD, CVD-mortality and overall mortality risk in women who have an early or premature menopause.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Association of Age at Onset of Menopause and Time Since Onset of Menopause With Cardiovascular Outcomes, Intermediate Vascular Traits, and All-Cause Mortality

et al. 2016

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“…Observational studies have shown a reduced risk of cardiovascular disease, [1][2][3][4] fewer calcifications in the aorta, 37 and less extensive atherosclerosis 38 in females with later menopause. In contrast, later menopause has been related to increased risk of breast cancer, 13,14 endometrial and ovarian cancer.…”

Section: Femalesmentioning

confidence: 99%

Age at Menopause and Mortality in Japan: the Jichi Medical School Cohort Study

Amagai

Ishikawa

Gotoh

et al. 2006

Journal of Epidemiology

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Communications. The people who moved out of the communities during the observation period were followed up until the date of the emigration. Data on emigration of the study subjects were obtained every year from their municipal governments.Age at menopause was categorized into <40 years, 40-44 years, 45-49 years, 50-54 years, and 55+ years. The reference group was females who were 45-49 years at menopause.Statistical analysis was performed using the SPSS ® software version 11.0. Descriptive parameters are shown as mean, standard deviation or proportion (%). We compared characteristics between the groups by one-way analyses of variance or the chisquare tests. Cox's proportional hazard models were used to calculate hazard ratios of mortality for age at menopause after adjusting for age, SBP, serum total cholesterol level, HDL cholesterol level, history of diabetes mellitus, BMI, smoking habits, alcohol drinking habits, marital status, study area, and type of menopause, which were considered to be potential confounding factors. Among the potential confounding factors that we obtained as the baseline data about blood pressure, we used SBP only in the multivariate analyses to avoid the co-linearity.This study was approved by the Institutional Review Board of Jichi Medical School for ethical issues.

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“…9,11 Also, studies reported an inverse relationship between age at natural menopause and mortality from CHD 12,13 and carotid atherosclerosis. 14 Bush et al demonstrated that HRT was associated with reduced all-cause mortality in postmenopausal women, 15 primarily because of favorable effects on high-density lipoprotein. 16 Barrett-Connor and Bush 8 reported that many, but not all, cross-sectional and prospective studies demonstrated a statistically significant reduction in CHD in women taking HRT, and Grady et al 17 presented a meta-analysis of published observational studies and reported that HRT was associated with one-third less fatal CHD.…”

Section: Observational Studies Suggest Hrt Has Beneficial Cardiovascumentioning

confidence: 99%

Hormone Replacement Therapy and Cardiovascular Disease

et al. 2004

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Abstract-Observational studies in humans and experimental studies in animals and isolated cells supported the widely held belief that hormone replacement therapy protects the cardiovascular system from disease. To nearly everyone's astonishment, the Women's Health Initiative Study and the Heart and Estrogen/Progestin Replacement Study overturned the conclusion that hormone replacement therapy protects the cardiovascular system and, in fact, supported the opposite view that such therapy may actually increase the risk of cardiovascular disease. Observational Studies Suggest HRT Has Beneficial Cardiovascular EffectsIn modern societies, cardiovascular disease is the main cause of morbidity and mortality in men and women. Women, however, are comparatively spared. For example, in people younger than age 65 years, the prevalence of coronary heart disease (CHD) is several-fold higher in men. 3,4 Although CHD prevalence increases with age in both genders, before the age of 65 years the relationship between age and CHD prevalence is shifted rightward by 5 years in women; 5,6 compared with postmenopausal women, CHD deaths are rare in premenopausal women. 7 Autopsy studies demonstrated increased CHD in oophorectomized young women, 8 and several studies demonstrated an increased risk of cardiovascular disease in women with bilateral oophorectomy without HRT compared with those receiving HRT. 9,10 Women with natural early-onset menopause who did not use HRT had a greater likelihood for CHD compared with age-matched premenopausal women. 9,11 Also, studies reported an inverse relationship between age at natural menopause and mortality from CHD 12,13 and carotid atherosclerosis. 14 Bush et al demonstrated that HRT was associated with reduced all-cause mortality in postmenopausal women, 15 primarily because of favorable effects on high-density lipoprotein. 16 Barrett-Connor and Bush 8 reported that many, but not all, cross-sectional and prospective studies demonstrated a statistically significant reduction in CHD in women taking HRT, and Grady et al 17 presented a meta-analysis of published observational studies and reported that HRT was associated with one-third less fatal CHD. An up-to-date meta-analysis of 25 observational studies conducted between 1976 and 1996 showed that the relative risk for CHD in women who ever used HRT compared with never users was 0.70. 18 The Nurses' Health Study was a comprehensive investigation conducted in 121 700 female nurses aged 30 to 55 years. In the latest report, compiled with data from 70 533 postmenopausal women followed-up for 20 years, the overall risk of CHD in current users of HRT was reduced, with a relative risk of 0.61 after adjustment for age and cardiovascular risk factors. 19

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Population-based study of age at menopause and ultrasound assessed carotid atherosclerosis

Cited by 111 publications

References 24 publications

Association of Age at Onset of Menopause and Time Since Onset of Menopause With Cardiovascular Outcomes, Intermediate Vascular Traits, and All-Cause Mortality

Association of Age at Onset of Menopause and Time Since Onset of Menopause With Cardiovascular Outcomes, Intermediate Vascular Traits, and All-Cause Mortality

Age at Menopause and Mortality in Japan: the Jichi Medical School Cohort Study

Hormone Replacement Therapy and Cardiovascular Disease

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