Author + information
- Shiva Raj Mishra,
- Hsin-Fang Chung,
- Michael Waller and
- Gita D. Mishra
Although previous studies have provided evidence on the effect of age at menarche and at menopause on mortality and cardiovascular diseases (CVD), little is known about the role of oestrogen exposure during reproductive years, and age at menarche and at menopause when they were both considered in the same analyses.
We conducted a systematic literature search in PubMed, EMBASE and Web of Science for studies published up to January 9, 2019. Studies were included if they reported risk of CVD events or all-cause/CVD-mortality in relationship to oestrogen exposure, or age at menarche and at menopause when both were considered in the same analysis. A total of 70 studies were included in the final analyses: oestrogen exposure (n=24), age at menarche (n=33) and age at menopause (n=59).
Three indices for measurement of oestrogen exposures were identified that included 1) reproductive duration (RD: the difference between age at menarche and age at menopause), 2) endogenous oestrogen exposure (EOE) (additionally accounting for the time for pregnancy, breastfeeding and use of oral contraceptives), and 3) total oestrogen exposure (TOE) (additionally accounting for duration of hormone replacement therapy). A longer RD was found to be associated with reduced risk of cardiovascular diseases (CVD: two studies, coronary artery disease: three studies, and stroke: four studies). The effect of EOE and TOE remained unclear. Early age at menarche (two studies) and at menopause (four studies) were associated with a higher risk of all-cause mortality compared to the middle age at menarche/menopause when they were both considered in the same analyses. Late age at menopause associated with reduced risk of stroke events in two studies and all-cause mortality in four studies. Association of age at menarche and at menopause with CVD events, CVD-mortality from these studies remained inconclusive.
Overall, a longer reproductive duration was associated with a reduced risk of CVD event particularly stroke. Early menarche and early menopause were found to be associated with a higher risk of all-cause mortality. Late menopause was associated with a lower risk of stroke and all-cause mortality.
Posters Hall_Hall A
Saturday, March 28, 2020, 12:30 p.m.-1:15 p.m.
Session Title: Spotlight on Special Topics: Global Cardiovascular Health 2
Abstract Category: 43. Spotlight on Special Topics: Global Cardiovascular Health
Presentation Number: 1173-270
- 2020 American College of Cardiology Foundation