Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data
Early menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence and timing of cardiovascular disease is unclear. We aimed to assess the associations between age at natural menopause and incidence and timing of cardiov...
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| Published in | The Lancet. Public health Vol. 4; no. 11; pp. e553 - e564 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Elsevier Ltd
01.11.2019
Elsevier, Ltd Elsevier |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2468-2667 2468-2667 |
| DOI | 10.1016/S2468-2667(19)30155-0 |
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| Abstract | Early menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence and timing of cardiovascular disease is unclear. We aimed to assess the associations between age at natural menopause and incidence and timing of cardiovascular disease.
We harmonised and pooled individual-level data from 15 observational studies done across five countries and regions (Australia, Scandinavia, the USA, Japan, and the UK) between 1946 and 2013. Women who had reported their menopause status, age at natural menopause (if postmenopausal), and cardiovascular disease status (including coronary heart disease and stroke) were included. We excluded women who had hysterectomy or oophorectomy and women who did not report their age at menopause. The primary endpoint of this study was the occurrence of first non-fatal cardiovascular disease, defined as a composite outcome of incident coronary heart disease (including heart attack and angina) or stroke (including ischaemic stroke or haemorrhagic stroke). We used Cox proportional hazards models to estimate multivariate hazard ratios (HRs) and 95% CIs for the associations between age at menopause and incident cardiovascular disease event. We also adjusted the model to account for smoking status, menopausal hormone therapy status, body-mass index, and education levels. Age at natural menopause was categorised as premenopausal or perimenopausal, younger than 40 years (premature menopause), 40–44 years (early menopause), 45–49 years (relatively early), 50–51 years (reference category), 52–54 years (relatively late), and 55 years or older (late menopause).
Overall, 301 438 women were included in our analysis. Of these 301 438 women, 12 962 (4·3%) had a first non-fatal cardiovascular disease event after menopause, of whom 9369 (3·1%) had coronary heart disease and 4338 (1·4%) had strokes. Compared with women who had menopause at age 50–51 years, the risk of cardiovascular disease was higher in women who had premature menopause (age <40 years; HR 1·55, 95% CI 1·38–1·73; p<0·0001), early menopause (age 40–44 years; 1·30, 1·22–1·39; p<0·0001), and relatively early menopause (age 45–49 years; 1·12, 1·07–1·18; p<0·0001), with a significantly reduced risk of cardiovascular disease following menopause after age 51 years (p<0·0001 for trend). The associations persisted in never smokers, and were strongest before age 60 years for women with premature menopause (HR 1·88, 1·62–2·20; p<0·0001) and early menopause (1·40, 1·27–1·54; p<0·0001), but were attenuated at age 60–69 years, with no significant association observed at age 70 years and older.
Compared with women who had menopause at age 50–51 years, women with premature and early menopause had a substantially increased risk of a non-fatal cardiovascular disease event before the age of 60 years, but not after age 70 years. Women with earlier menopause need close monitoring in clinical practice, and age at menopause might also be considered as an important factor in risk stratification of cardiovascular disease for women.
Australian National Health and Medical Research Council. |
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| AbstractList | SummaryBackgroundEarly menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence and timing of cardiovascular disease is unclear. We aimed to assess the associations between age at natural menopause and incidence and timing of cardiovascular disease. MethodsWe harmonised and pooled individual-level data from 15 observational studies done across five countries and regions (Australia, Scandinavia, the USA, Japan, and the UK) between 1946 and 2013. Women who had reported their menopause status, age at natural menopause (if postmenopausal), and cardiovascular disease status (including coronary heart disease and stroke) were included. We excluded women who had hysterectomy or oophorectomy and women who did not report their age at menopause. The primary endpoint of this study was the occurrence of first non-fatal cardiovascular disease, defined as a composite outcome of incident coronary heart disease (including heart attack and angina) or stroke (including ischaemic stroke or haemorrhagic stroke). We used Cox proportional hazards models to estimate multivariate hazard ratios (HRs) and 95% CIs for the associations between age at menopause and incident cardiovascular disease event. We also adjusted the model to account for smoking status, menopausal hormone therapy status, body-mass index, and education levels. Age at natural menopause was categorised as premenopausal or perimenopausal, younger than 40 years (premature menopause), 40–44 years (early menopause), 45–49 years (relatively early), 50–51 years (reference category), 52–54 years (relatively late), and 55 years or older (late menopause). FindingsOverall, 301 438 women were included in our analysis. Of these 301 438 women, 12 962 (4·3%) had a first non-fatal cardiovascular disease event after menopause, of whom 9369 (3·1%) had coronary heart disease and 4338 (1·4%) had strokes. Compared with women who had menopause at age 50–51 years, the risk of cardiovascular disease was higher in women who had premature menopause (age <40 years; HR 1·55, 95% CI 1·38–1·73; p<0·0001), early menopause (age 40–44 years; 1·30, 1·22–1·39; p<0·0001), and relatively early menopause (age 45–49 years; 1·12, 1·07–1·18; p<0·0001), with a significantly reduced risk of cardiovascular disease following menopause after age 51 years (p<0·0001 for trend). The associations persisted in never smokers, and were strongest before age 60 years for women with premature menopause (HR 1·88, 1·62–2·20; p<0·0001) and early menopause (1·40, 1·27–1·54; p<0·0001), but were attenuated at age 60–69 years, with no significant association observed at age 70 years and older. InterpretationCompared with women who had menopause at age 50–51 years, women with premature and early menopause had a substantially increased risk of a non-fatal cardiovascular disease event before the age of 60 years, but not after age 70 years. Women with earlier menopause need close monitoring in clinical practice, and age at menopause might also be considered as an important factor in risk stratification of cardiovascular disease for women. FundingAustralian National Health and Medical Research Council. Early menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence and timing of cardiovascular disease is unclear. We aimed to assess the associations between age at natural menopause and incidence and timing of cardiovascular disease. We harmonised and pooled individual-level data from 15 observational studies done across five countries and regions (Australia, Scandinavia, the USA, Japan, and the UK) between 1946 and 2013. Women who had reported their menopause status, age at natural menopause (if postmenopausal), and cardiovascular disease status (including coronary heart disease and stroke) were included. We excluded women who had hysterectomy or oophorectomy and women who did not report their age at menopause. The primary endpoint of this study was the occurrence of first non-fatal cardiovascular disease, defined as a composite outcome of incident coronary heart disease (including heart attack and angina) or stroke (including ischaemic stroke or haemorrhagic stroke). We used Cox proportional hazards models to estimate multivariate hazard ratios (HRs) and 95% CIs for the associations between age at menopause and incident cardiovascular disease event. We also adjusted the model to account for smoking status, menopausal hormone therapy status, body-mass index, and education levels. Age at natural menopause was categorised as premenopausal or perimenopausal, younger than 40 years (premature menopause), 40-44 years (early menopause), 45-49 years (relatively early), 50-51 years (reference category), 52-54 years (relatively late), and 55 years or older (late menopause). Overall, 301 438 women were included in our analysis. Of these 301 438 women, 12 962 (4·3%) had a first non-fatal cardiovascular disease event after menopause, of whom 9369 (3·1%) had coronary heart disease and 4338 (1·4%) had strokes. Compared with women who had menopause at age 50-51 years, the risk of cardiovascular disease was higher in women who had premature menopause (age <40 years; HR 1·55, 95% CI 1·38-1·73; p<0·0001), early menopause (age 40-44 years; 1·30, 1·22-1·39; p<0·0001), and relatively early menopause (age 45-49 years; 1·12, 1·07-1·18; p<0·0001), with a significantly reduced risk of cardiovascular disease following menopause after age 51 years (p<0·0001 for trend). The associations persisted in never smokers, and were strongest before age 60 years for women with premature menopause (HR 1·88, 1·62-2·20; p<0·0001) and early menopause (1·40, 1·27-1·54; p<0·0001), but were attenuated at age 60-69 years, with no significant association observed at age 70 years and older. Compared with women who had menopause at age 50-51 years, women with premature and early menopause had a substantially increased risk of a non-fatal cardiovascular disease event before the age of 60 years, but not after age 70 years. Women with earlier menopause need close monitoring in clinical practice, and age at menopause might also be considered as an important factor in risk stratification of cardiovascular disease for women. Australian National Health and Medical Research Council. Early menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence and timing of cardiovascular disease is unclear. We aimed to assess the associations between age at natural menopause and incidence and timing of cardiovascular disease.BACKGROUNDEarly menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence and timing of cardiovascular disease is unclear. We aimed to assess the associations between age at natural menopause and incidence and timing of cardiovascular disease.We harmonised and pooled individual-level data from 15 observational studies done across five countries and regions (Australia, Scandinavia, the USA, Japan, and the UK) between 1946 and 2013. Women who had reported their menopause status, age at natural menopause (if postmenopausal), and cardiovascular disease status (including coronary heart disease and stroke) were included. We excluded women who had hysterectomy or oophorectomy and women who did not report their age at menopause. The primary endpoint of this study was the occurrence of first non-fatal cardiovascular disease, defined as a composite outcome of incident coronary heart disease (including heart attack and angina) or stroke (including ischaemic stroke or haemorrhagic stroke). We used Cox proportional hazards models to estimate multivariate hazard ratios (HRs) and 95% CIs for the associations between age at menopause and incident cardiovascular disease event. We also adjusted the model to account for smoking status, menopausal hormone therapy status, body-mass index, and education levels. Age at natural menopause was categorised as premenopausal or perimenopausal, younger than 40 years (premature menopause), 40-44 years (early menopause), 45-49 years (relatively early), 50-51 years (reference category), 52-54 years (relatively late), and 55 years or older (late menopause).METHODSWe harmonised and pooled individual-level data from 15 observational studies done across five countries and regions (Australia, Scandinavia, the USA, Japan, and the UK) between 1946 and 2013. Women who had reported their menopause status, age at natural menopause (if postmenopausal), and cardiovascular disease status (including coronary heart disease and stroke) were included. We excluded women who had hysterectomy or oophorectomy and women who did not report their age at menopause. The primary endpoint of this study was the occurrence of first non-fatal cardiovascular disease, defined as a composite outcome of incident coronary heart disease (including heart attack and angina) or stroke (including ischaemic stroke or haemorrhagic stroke). We used Cox proportional hazards models to estimate multivariate hazard ratios (HRs) and 95% CIs for the associations between age at menopause and incident cardiovascular disease event. We also adjusted the model to account for smoking status, menopausal hormone therapy status, body-mass index, and education levels. Age at natural menopause was categorised as premenopausal or perimenopausal, younger than 40 years (premature menopause), 40-44 years (early menopause), 45-49 years (relatively early), 50-51 years (reference category), 52-54 years (relatively late), and 55 years or older (late menopause).Overall, 301 438 women were included in our analysis. Of these 301 438 women, 12 962 (4·3%) had a first non-fatal cardiovascular disease event after menopause, of whom 9369 (3·1%) had coronary heart disease and 4338 (1·4%) had strokes. Compared with women who had menopause at age 50-51 years, the risk of cardiovascular disease was higher in women who had premature menopause (age <40 years; HR 1·55, 95% CI 1·38-1·73; p<0·0001), early menopause (age 40-44 years; 1·30, 1·22-1·39; p<0·0001), and relatively early menopause (age 45-49 years; 1·12, 1·07-1·18; p<0·0001), with a significantly reduced risk of cardiovascular disease following menopause after age 51 years (p<0·0001 for trend). The associations persisted in never smokers, and were strongest before age 60 years for women with premature menopause (HR 1·88, 1·62-2·20; p<0·0001) and early menopause (1·40, 1·27-1·54; p<0·0001), but were attenuated at age 60-69 years, with no significant association observed at age 70 years and older.FINDINGSOverall, 301 438 women were included in our analysis. Of these 301 438 women, 12 962 (4·3%) had a first non-fatal cardiovascular disease event after menopause, of whom 9369 (3·1%) had coronary heart disease and 4338 (1·4%) had strokes. Compared with women who had menopause at age 50-51 years, the risk of cardiovascular disease was higher in women who had premature menopause (age <40 years; HR 1·55, 95% CI 1·38-1·73; p<0·0001), early menopause (age 40-44 years; 1·30, 1·22-1·39; p<0·0001), and relatively early menopause (age 45-49 years; 1·12, 1·07-1·18; p<0·0001), with a significantly reduced risk of cardiovascular disease following menopause after age 51 years (p<0·0001 for trend). The associations persisted in never smokers, and were strongest before age 60 years for women with premature menopause (HR 1·88, 1·62-2·20; p<0·0001) and early menopause (1·40, 1·27-1·54; p<0·0001), but were attenuated at age 60-69 years, with no significant association observed at age 70 years and older.Compared with women who had menopause at age 50-51 years, women with premature and early menopause had a substantially increased risk of a non-fatal cardiovascular disease event before the age of 60 years, but not after age 70 years. Women with earlier menopause need close monitoring in clinical practice, and age at menopause might also be considered as an important factor in risk stratification of cardiovascular disease for women.INTERPRETATIONCompared with women who had menopause at age 50-51 years, women with premature and early menopause had a substantially increased risk of a non-fatal cardiovascular disease event before the age of 60 years, but not after age 70 years. Women with earlier menopause need close monitoring in clinical practice, and age at menopause might also be considered as an important factor in risk stratification of cardiovascular disease for women.Australian National Health and Medical Research Council.FUNDINGAustralian National Health and Medical Research Council. Background: Early menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence and timing of cardiovascular disease is unclear. We aimed to assess the associations between age at natural menopause and incidence and timing of cardiovascular disease. Methods: We harmonised and pooled individual-level data from 15 observational studies done across five countries and regions (Australia, Scandinavia, the USA, Japan, and the UK) between 1946 and 2013. Women who had reported their menopause status, age at natural menopause (if postmenopausal), and cardiovascular disease status (including coronary heart disease and stroke) were included. We excluded women who had hysterectomy or oophorectomy and women who did not report their age at menopause. The primary endpoint of this study was the occurrence of first non-fatal cardiovascular disease, defined as a composite outcome of incident coronary heart disease (including heart attack and angina) or stroke (including ischaemic stroke or haemorrhagic stroke). We used Cox proportional hazards models to estimate multivariate hazard ratios (HRs) and 95% CIs for the associations between age at menopause and incident cardiovascular disease event. We also adjusted the model to account for smoking status, menopausal hormone therapy status, body-mass index, and education levels. Age at natural menopause was categorised as premenopausal or perimenopausal, younger than 40 years (premature menopause), 40–44 years (early menopause), 45–49 years (relatively early), 50–51 years (reference category), 52–54 years (relatively late), and 55 years or older (late menopause). Findings: Overall, 301 438 women were included in our analysis. Of these 301 438 women, 12 962 (4·3%) had a first non-fatal cardiovascular disease event after menopause, of whom 9369 (3·1%) had coronary heart disease and 4338 (1·4%) had strokes. Compared with women who had menopause at age 50–51 years, the risk of cardiovascular disease was higher in women who had premature menopause (age <40 years; HR 1·55, 95% CI 1·38–1·73; p<0·0001), early menopause (age 40–44 years; 1·30, 1·22–1·39; p<0·0001), and relatively early menopause (age 45–49 years; 1·12, 1·07–1·18; p<0·0001), with a significantly reduced risk of cardiovascular disease following menopause after age 51 years (p<0·0001 for trend). The associations persisted in never smokers, and were strongest before age 60 years for women with premature menopause (HR 1·88, 1·62–2·20; p<0·0001) and early menopause (1·40, 1·27–1·54; p<0·0001), but were attenuated at age 60–69 years, with no significant association observed at age 70 years and older. Interpretation: Compared with women who had menopause at age 50–51 years, women with premature and early menopause had a substantially increased risk of a non-fatal cardiovascular disease event before the age of 60 years, but not after age 70 years. Women with earlier menopause need close monitoring in clinical practice, and age at menopause might also be considered as an important factor in risk stratification of cardiovascular disease for women. Funding: Australian National Health and Medical Research Council. |
| Author | Avis, Nancy E Chung, Hsin-Fang Brunner, Eric J Mizunuma, Hideki Anderson, Debra Brown, Daniel E Simonsen, Mette Kildevæld Derby, Carol A Tillin, Therese Lee, Jung Su Weiderpass, Elisabete Matthews, Karen A Cade, Janet E Kuh, Diana Greenwood, Darren C Sievert, Lynnette L Adami, Hans-Olov Zhu, Dongshan Bruinsma, Fiona Hardy, Rebecca Mishra, Gita D Pandeya, Nirmala Demakakos, Panayotes Giles, Graham G Gold, Ellen B Hayashi, Kunihiko Dobson, Annette J |
| AuthorAffiliation | t Parker Institute, Copenhagen University Hospital, Frederiksberg, Denmark m Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK g Institute of Cardiovascular Science, University College London, London, UK i Department of Public Health Sciences, University of California, Davis School of Medicine, Davis, CA, USA e Department of Epidemiology and Public Health, University College London, London, UK s Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan x International Agency for Research on Cancer, World Health Organization, Lyon, France k Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA n Department of Anthropology, University of Hawaii, Hilo, HI, USA l Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA q School of Health Sciences, Gunma University, Maebashi, Japan o Department of Anthropology, University of Massachusetts Amherst, A |
| AuthorAffiliation_xml | – name: j Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA – name: a School of Public Health, University of Queensland, Brisbane, QLD, Australia – name: e Department of Epidemiology and Public Health, University College London, London, UK – name: m Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK – name: p Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia – name: f Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK – name: q School of Health Sciences, Gunma University, Maebashi, Japan – name: h Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA – name: w Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway – name: g Institute of Cardiovascular Science, University College London, London, UK – name: o Department of Anthropology, University of Massachusetts Amherst, Amherst, MA, USA – name: s Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan – name: b Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia – name: c Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia – name: d Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia – name: u Aarhus University, Aarhus, Denmark – name: n Department of Anthropology, University of Hawaii, Hilo, HI, USA – name: x International Agency for Research on Cancer, World Health Organization, Lyon, France – name: i Department of Public Health Sciences, University of California, Davis School of Medicine, Davis, CA, USA – name: r Department of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan – name: t Parker Institute, Copenhagen University Hospital, Frederiksberg, Denmark – name: k Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA – name: v Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden – name: l Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA |
| Author_xml | – sequence: 1 givenname: Dongshan surname: Zhu fullname: Zhu, Dongshan organization: School of Public Health, University of Queensland, Brisbane, QLD, Australia – sequence: 2 givenname: Hsin-Fang surname: Chung fullname: Chung, Hsin-Fang organization: School of Public Health, University of Queensland, Brisbane, QLD, Australia – sequence: 3 givenname: Annette J surname: Dobson fullname: Dobson, Annette J organization: School of Public Health, University of Queensland, Brisbane, QLD, Australia – sequence: 4 givenname: Nirmala surname: Pandeya fullname: Pandeya, Nirmala organization: School of Public Health, University of Queensland, Brisbane, QLD, Australia – sequence: 5 givenname: Graham G surname: Giles fullname: Giles, Graham G organization: Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia – sequence: 6 givenname: Fiona surname: Bruinsma fullname: Bruinsma, Fiona organization: Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia – sequence: 7 givenname: Eric J surname: Brunner fullname: Brunner, Eric J organization: Department of Epidemiology and Public Health, University College London, London, UK – sequence: 8 givenname: Diana surname: Kuh fullname: Kuh, Diana organization: Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK – sequence: 9 givenname: Rebecca surname: Hardy fullname: Hardy, Rebecca organization: Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK – sequence: 10 givenname: Nancy E surname: Avis fullname: Avis, Nancy E organization: Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA – sequence: 11 givenname: Ellen B surname: Gold fullname: Gold, Ellen B organization: Department of Public Health Sciences, University of California, Davis School of Medicine, Davis, CA, USA – sequence: 12 givenname: Carol A surname: Derby fullname: Derby, Carol A organization: Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA – sequence: 13 givenname: Karen A surname: Matthews fullname: Matthews, Karen A organization: Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA – sequence: 14 givenname: Janet E surname: Cade fullname: Cade, Janet E organization: Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK – sequence: 15 givenname: Darren C surname: Greenwood fullname: Greenwood, Darren C organization: Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK – sequence: 16 givenname: Panayotes surname: Demakakos fullname: Demakakos, Panayotes organization: Department of Epidemiology and Public Health, University College London, London, UK – sequence: 17 givenname: Daniel E surname: Brown fullname: Brown, Daniel E organization: Department of Anthropology, University of Hawaii, Hilo, HI, USA – sequence: 18 givenname: Lynnette L surname: Sievert fullname: Sievert, Lynnette L organization: Department of Anthropology, University of Massachusetts Amherst, Amherst, MA, USA – sequence: 19 givenname: Debra surname: Anderson fullname: Anderson, Debra organization: Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia – sequence: 20 givenname: Kunihiko surname: Hayashi fullname: Hayashi, Kunihiko organization: School of Health Sciences, Gunma University, Maebashi, Japan – sequence: 21 givenname: Jung Su surname: Lee fullname: Lee, Jung Su organization: Department of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan – sequence: 22 givenname: Hideki surname: Mizunuma fullname: Mizunuma, Hideki organization: Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan – sequence: 23 givenname: Therese surname: Tillin fullname: Tillin, Therese organization: Institute of Cardiovascular Science, University College London, London, UK – sequence: 24 givenname: Mette Kildevæld surname: Simonsen fullname: Simonsen, Mette Kildevæld organization: Parker Institute, Copenhagen University Hospital, Frederiksberg, Denmark – sequence: 25 givenname: Hans-Olov surname: Adami fullname: Adami, Hans-Olov organization: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden – sequence: 26 givenname: Elisabete surname: Weiderpass fullname: Weiderpass, Elisabete organization: International Agency for Research on Cancer, World Health Organization, Lyon, France – sequence: 27 givenname: Gita D surname: Mishra fullname: Mishra, Gita D email: g.mishra@uq.edu.au organization: School of Public Health, University of Queensland, Brisbane, QLD, Australia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31588031$$D View this record in MEDLINE/PubMed http://kipublications.ki.se/Default.aspx?queryparsed=id:142253230$$DView record from Swedish Publication Index |
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| PublicationDate | 2019-11-01 |
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| PublicationTitle | The Lancet. Public health |
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| PublicationYear | 2019 |
| Publisher | Elsevier Ltd Elsevier, Ltd Elsevier |
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| Snippet | Early menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence and timing... SummaryBackgroundEarly menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and... Background: Early menopause is linked to an increased risk of cardiovascular disease mortality; however, the association between early menopause and incidence... |
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| SubjectTerms | Adult Age Factors Aged Body Mass Index Cardiovascular Diseases - epidemiology Coronary Disease - epidemiology Educational Status Estrogen Replacement Therapy - statistics & numerical data Female Humans Incidence Internal Medicine Menopause Middle Aged Observational Studies as Topic Proportional Hazards Models Public Health Risk Assessment Risk Factors Smoking - epidemiology Stroke - epidemiology Time Factors |
| Title | Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data |
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