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Early, late menarche may increase risk for vascular disease
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A new study reported a relationship between age at menarche and risk for vascular disease.
The magnitude of risk was greater for menarche at age 10 years or younger and at age 17 years or older. The risk for CHD related to age at menarche was higher than risk for cerebrovascular or hypertensive disease, researchers found.
Previous research showed an association between early menarche and CHD, but those studies were small, did not assess a wide range of menarcheal ages and usually did not investigate associations with other vascular diseases, researchers wrote in the study background.
Dexter Canoy
Dexter Canoy, MD, PhD, MPhil, and colleagues examined coronary, cerebrovascular and hypertensive disease risks by age at menarche in participants from the Million Women Study in the United Kingdom who reported age at menarche and had no hospitalization for heart disease, stroke or other cerebrovascular disease, or cancer at baseline. The cohort included 1,217,840 participants (mean age, 56 years).
Women were stratified by age at menarche: 24.5% reported menarche at age 13 years, 3.9% at age 10 years or younger and 1.4% at age 17 years or older. Mean follow-up was 11.6 years.
The researchers documented 73,378 first hospitalizations or deaths from CHD, 25,426 for cerebrovascular disease and 249,426 for hypertensive disease during the study period.
Compared with menarche at age 13 years, menarche at age 10 years or younger (adjusted RR=1.27; 95% CI, 1.22-1.31) and menarche at age 17 years or older (adjusted RR=1.23; 95% CI, 1.16-1.3) were associated with increased risk for CHD.
Results also demonstrated an increased risk for cerebrovascular disease in women with menarche at age 10 years or younger (adjusted RR=1.16; 95% CI, 1.09-1.23) and in those with menarche at age 17 years or older (adjusted RR=1.13; 95% CI, 1.03-1.24). A similar pattern was observed for hypertensive disease, according to the researchers.
For CHD mortality, compared with menarche at age 13 years, menarche at age 11 years or younger was associated with greater risk (adjusted RR=1.12; 95% CI, 1.02-1.22). The same trend was not observed for CHD mortality and menarche at age 16 years or older (adjusted RR=1.02; 95% CI, 0.9-1.15).
These associations were observed regardless of weight, smoking status and socioeconomic status, according to the researchers.
“Childhood obesity, widespread in many industrialized countries, is linked particularly to early age at which the first menstrual cycle occurs,” Canoy, a cardiovascular epidemiologist in the cancer epidemiology unit at the Nuffield Department of Population Health, University of Oxford, said in a press release. “Public health strategies to tackle childhood obesity may possibly prevent the lowering of the average age of first menstrual cycle, which may in turn reduce their risk of developing heart disease over the long term.”
Disclosure: The study was supported by Cancer Research UK, the Medical Research Council, the NHS Cancer Screening Programme and the British Heart Foundation. The researchers report no relevant financial disclosures.
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