Heart disease risk factors may bring on menopause

Women with more risk factors for cardiovascular disease tend to enter menopause earlier than women without cardiovascular risk factors, according to an analysis of data from the Framingham Heart Study.

Dr. Yvonne T. van der Schouw, from Utrecht University in the Netherlands, and colleagues evaluated data from the records of 695 women who were pre-menopausal at study entry in 1948 and who reached natural menopause after at least two biennial examinations.

The women ranged in age from 34 to 55 years when they enrolled in the study, and their age at menopause was 38 to 58 years.

If the women were smokers at age 43, they began menopause an average of 1.6 years earlier than non-smokers, the investigators found.

Similarly, each 20-point increased in cholesterol level before menopause was associated with a 0.14-year earlier onset of menopause, the team reports in the Journal of the American College of Cardiology.

Women with higher blood pressure also had a younger age at menopause onset.

Women who either gained or lost weight during the premenopausal period had a significantly earlier age of onset.

Dr. van der Schouw's team notes that, while their data suggest that cardiovascular risk factors may be determine when menopause begins, the converse may also be true - that early menopause with its decreased estrogen levels increases the risk of cardiovascular disease.

In a related editorial, Dr. Vera Bittner, in Birmingham, Alabama, points out that the average age of menopause onset is similar in countries around the globe, whereas cardiovascular risk factors vary widely. This suggests that "the effect of cardiovascular disease risk factors on menopausal age is at most modest."

SOURCE: Journal of the American College of Cardiology, May 16, 2006.