Later menarche associated with better cardiovascular health
Women who had menarche at a later age are more likely to have better cardiovascular health, according to a study published in Menopause.
“Previous studies showed that age at menarche is associated with CVD,” Hui Hu, PhD, assistant professor in the department of epidemiology at the College of Public Health and Health Professions and College of Medicine, University of Florida, told Healio. “The findings from our study further suggested that age at menarche may play an important role in maintaining and improving cardiovascular health, even among women without any CVD. Age of menarche may be used to identify those with poor cardiovascular health so that targeted interventions can be implemented.”
Hu and colleagues analyzed data from the 1999-2016 National Health and Nutrition Examination Survey. The study included 20,447 women aged at least 18 years with information on age at menarche. CV health scores were given based on interview answers about smoking, physical activity and diet, examination of blood pressure and BMI, and measures of total cholesterol and glucose. Participants received a score of zero for poor, one for intermediate and two for ideal on each of the seven metrics, with women scoring ideal on at least four metrics considered to have ideal CV health. Age at menarche was designated “normal” for menarche at age 12 or 13 years (n = 4,834), “early” at age 6 to 11 years (n = 1,987) and “late” at age 14 years or older (n = 2,585).
Of the study’s total participants, 11.2% were categorized as having ideal CV health. In a model adjusting for age, race/ethnicity, education, poverty income status, marital status and birth year, women with early menarche had lower likelihood of having ideal CV health than those who had menarche at normal age (adjusted OR = 0.7; 95% CI, 0.6-0.82), whereas women with late menarche were more likely to have ideal CV health (aOR = 1.4; 95% CI, 1.21-1.62). Each 1-year increase in age at menarche represented a 17% higher likelihood of ideal CV health.
Late menarche was significantly associated with better odds for ideal CV health for women aged 25 to 34 years (OR = 1.63; 95% CI, 1.26-2.1) and those aged 35 to 44 years (OR = 1.74; 95% CI, 1.31-2.3). Early menarche was associated with a lower likelihood for ideal CV health in women aged 25 to 34 years (OR = 0.72; 95% CI, 0.53-0.97).
“We observed significant age differences, with significant associations observed among women aged 25 to 44 years,” Hu said. “One potential reason underlying the observed age difference is that age at menarche, as a risk factor for cardiovascular health, may become less important over time since there might be other competing factors among older women, which can mitigate the associations.”
A total of 9,406 women completed all seven CV health metrics. For this group, the sum of all seven metrics was calculated with a maximum score of 14. A higher score indicated better CV health.
Those who completed all seven metrics had a mean CV health score of 8.21 (95% CI, 8.19-8.25). Women with early menarche had lower CV scores (adjusted beta = 0.4; 95% CI, –0.55 to –0.25) while those with late menarche had higher scores (adjusted beta = 0.27; 95% CI, 0.13-0.42). Each 1-year increase in age at menarche was worth an additional 0.14 points in CV score.
The findings showed that age at menarche may be an important predictor for CV health, but Hu said additional longitudinal studies are needed to explore how age at menarche changes the trajectory of CV health over time.
For more information:
Hui Hu, PhD, can be reached at huihu@ufl.edu.
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