18 Dec Age of Menarche Linked To Heart Disease Onset
MedicalResearch.com Interview with:
Dexter Canoy, PhD
Cancer Epidemiology Unit, Nuffield Department of Population Health
University of Oxford, United Kingdom
Medical Research: What is the background for this study? What are the main findings?
Response: Over a million middle-aged women in the UK who took part in our study between 1996 and 2001 provided information regarding their health and lifestyle, including their reproductive history such as age when they had their first menstruation. We followed them for over 10 years and identified those who developed heart disease (and other vascular diseases) by obtaining information on hospitalizations and death records. Our study demonstrates that on average, women with menarche before age 13 or after this age have slightly increased risks of developing heart disease, stroke and hospital admissions associated with hypertension. The increased risks for these vascular diseases were highest in women with menarche at age 10 years or younger, or age 17 years or older. This U-shaped association was consistently found among lean, overweight and obese women, among never, past or current smokers, or among women in low, middle or high socioeconomic group.
Medical Research: What should clinicians and patients take away from your report?
Response: We now understand that the timing of the first menstrual cycle could have a long-term influence on women’s vascular health. However, differences in risks of vascular disease between single years of menarcheal age are relatively small. And since only a small proportion of women had very early (≤10 years) or late age (≥17 years) when their first menstruation started, the risk for developing heart disease or cerebrovascular disease is likely to be relatively small for the majority of women. While age at menarche is a ‘non-modifiable’ characteristic of adult women, obesity is common among those with early menarche so there is scope for ‘modifying’ their risk by reducing their excess weight. However, age at menarche is a trait that could be potentially modified during childhood. Childhood overweight and obesity, which is prevalent in many industrialized countries, are closely linked with early age at menarche. Strategies to prevent excess weight gain during childhood may prevent menarche occurring at an earlier age than necessary, which in turn could reduce the risk of developing heart disease and stroke in the long-term.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: Future research may require investigating at least two different age groups, one involving adult women, and the other involving children. For adult women, there is a need to explore the relation of age at menarche and vascular health in populations where the distribution of mean age at menarche differs substantially to Western women to allow us to examine in more detail the consistency of our findings, or lack thereof, in such populations. The results should provide further clues to what might the underlying mechanisms be of our observations. Research should also examine the population determinants of pubertal (and menarcheal) timing, as there may be different factors involved in the early or delayed onset of menstruation, and what their impact is on vascular physiology during this time period. If there is an impact on the vascular milieu, it would be useful to demonstrate if the effect is transient or permanent.
Citation:
Age at Menarche and Risks of Coronary Heart and Other Vascular Diseases in a Large UK Cohort
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Last Updated on December 18, 2014 by Marie Benz MD FAAD