Risk and Age of Cardiovascular Event in Women with Metabolic Syndrome: Menopause Age in Focus

Abstract

Background: There is still a controversy about the causal relationship between menopause status and cardiovascular disease (CVD). The present study aimed to evaluate whether premature menopause would predict higher risk and lower the age of CVD occurrence and how this differs in women with metabolic syndrome (MetS). Methods: Using a population-based Isfahan Cohort Study (ICS), 1154 postmenopause women were followed up from 2001 to 2013 for any CVD occurrence. Cox proportional hazards regression analyses were used to estimate the association between menopause age of (45, 46-50, 51-55, 56 years) and CVD incidence. The menopause age group of 46-50 years was considered as reference group. Results: During 12 years follow-up, 235 CV events were recorded. The mean age of menopause (standard deviation) was 48.06 +/- 5.48 years. The age at menopause was not predictive of total CV events, in women with and without MetS. In women without MetS, a trend with increasing incidence of stroke was observed at menopause age of 45 years (age adjusted hazard ratio: 4.84, 95 confidence interval: 0.99-23.5, P=0.05). Women with menopause age of 45 years suffered from CV events, 5.7 years earlier than women with menopause age of 56 years (P=0.11); this difference was 5.3 years in women with MetS (P=0.4). Conclusion: This study showed that younger age at menopause is not predictive of the occurrence of CV events. It also revealed that age at menopause is not associated with earlier CV events in postmenopause women, with and without MetS.