Shorter reproductive lifespan linked to doubled CVD risk in women

  • Mishra SR & al.
  • JAMA Cardiol
  • 16/09/2020

  • Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • For women, a short reproductive lifespan (

Why this matters

  • Results of previous large studies and meta-analyses have been mixed in terms of the association between CVD event risk or mortality and age at menarche or menopause or reproductive lifespan.
  • These authors used individual-level data for more than 300,000 women, pooled from 12 studies.

Key results

  • Data for 307,855 women included.
  • Averages (standard deviations), in years:
    • Age at menarche: 13.0 (1.5).
    • Age at menopause: 50.2 (4.4).
    • Reproductive lifespan: 37.2 (4.6).
  • Adjusted HR for incident CVD event:
    • Reproductive lifespan
    • This risk decreased to 1.26 (95% CI, 1.09-1.46) when adjusted for age at menopause, suggesting that this age is an important factor.
  • Very early (≤10 years) or late (≥16 years) menarche was associated with similarly increased CVD risk.
  • Menopause after age 55 years was linked to reduced CVD risk.
  • Women who had both a shorter reproductive lifespan and early menarche (≤11 vs 13 years) had doubled risk for a CVD event:
    • HR, 2.06 (95% CI, 1.76-2.41).

Study design

  • Studies from the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events consortium.
  • Funding: Australian National Health and Medical Research Council; others.

Limitations

  • Mostly recall-based reproductive data.
  • CVD events largely based on self-report.