By Frances Morin
BOSTON -- May 18, 2015 -- Women who experience menopause before age 44 years show a decreased risk of developing atrial fibrillation (AF) than women who undergo menopause at an older age, according to research presented here at the 36th Annual Scientific Sessions of the Heart Rhythm Society (HRS).
Although early menopause has previously been associated with an increased risk of cardiovascular disease and stroke, the new study, which is the largest of its kind, shows otherwise for AF.
“In this study, we found that earlier age at menopause was associated with a decreased risk of incident AF,” said Jorge A. Wong, MD, Brigham and Women’s Hospital, Boston, Massachusetts, on May 15. “This is in contrast with the relationship we see between early menopause and coronary heart disease and stroke, where earlier age at menopause has been associated with elevations in risk.”
The study involved 17,932 women aged ≥45 years who were enrolled in the Women’s Health Study based at Brigham and Women’s Hospital at Harvard Medical School. The average age of the patients was 58 years and the average age of menopause for the women was 48 years.
In prospectively following the women for an average follow-up of 19 years, the researchers found that 986 women developed AF.
Women who underwent menopause before age 44 years had a significantly decreased risk of AF compared with those reporting menopause between the ages of 44 and 50 years (adjusted hazard ratio, 0.83; 95% confidence interval, 0.70-0.99). The association remained after adjusting for surgery- or chemotherapy-induced menopause. A correlation between older age (>50 years) at menopause and AF risk was not seen.
The researchers speculate that there may be a link between longer exposure to endogenous oestrogen and the development of heart arrhythmia.
“The results provide insight into the complicated and often divergent pathways leading to AF and heart disease in women,” concluded Dr. Wong.
[Presentation title: Age of Menopause and Atrial Fibrillation: Insights From the Women’s Health Study. Abstract AB33-01]
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