Timing of Menarche/Menopause and Adverse Pregnancy Outcomes Linked to CVD Risk

Two studies suggest that reproductive life span and adverse pregnancy outcomes are sex-specific risk factors for atherosclerotic cardiovascular disease (CVD) in women. One study included 307 855 women from 12 studies. Overall, the mean ages at menarche, menopause, and reproductive life span were 13.0, 50.2, and 37.2 years, respectively. Pooled analyses showed that women with a very short reproductive life span (<30 years) were at 1.71 times higher risk of incident CVD events than women with a reproductive life span of 36 to 38 years after adjustment for covariates. This association remained unchanged when adjusted for age at menarche but was attenuated to 1.26 when adjusted for age at menopause. Women who had both short reproductive life span (<33 years) and early menarche (age ≤11 years) had the highest risk of CVD (hazard ratio [HR], 2.06) compared with those with a reproductive life span of 36 to 38 years and menarche at age 13 years. Another US study included 48 113 women, 28.8% reported 1 or more common adverse pregnancy outcomes (APOs). Atherosclerotic CVD (ASCVD) was more frequent in women who reported an APO compared with those without APOs (7.6% vs 5.8%). Each APO, analyzed separately, was significantly associated with ASCVD, and gestational diabetes, hypertensive disorders of pregnancy, low birth weight, and preterm delivery remained significant after adjustment for traditional ASCVD risk factors. When all APOs were analyzed together, hypertensive disorders of pregnancy (HR 1.27) and low birth weight (HR 1.12) remained independently associated with ASCVD. The findings suggest that the timing and events of women’s child-bearing years should be considered for their CVD risk assessment. Source: https://jamanetwork.com/