Early menopause and risk of cardiovascular disease: an issue for young women

Despite an overall reduction in cardiovascular disease mortality in the past 40 years, cardiovascular disease remains the leading cause of death worldwide, with gender disparities. Women tend to present with cardiovascular disease up to 10 years later than men, although age-adjusted rates of cardiovascular disease mortality in women are similar to men, and account for more deaths than any other cause. Since women have a longer life expectancy than men, the absolute number of cardiovascular disease deaths is higher among women than men and increasing cardiovascular disease mortality rates have been observed in women younger than 55 years.1 Although gender differences with regard to risk factors, aetiology, and outcomes of cardiovascular disease are well established, a unique group of sex-specific risk factors associated with reproductive health have been identified in women. Previous evidence is inconsistent, but a number of factors including early menarche or menopause have been associated with future cardiovascular disease events in women.2 Up to 10% of women have early natural menopause,3 indicating a potentially important target population for early and tailored risk stratification. In The Lancet Public Health, Dongshan Zhu and colleagues4 report one of the largest studies to date to investigate the association between age at menopause and onset and timing of incident cardiovascular disease.