Are Heart Disease, Stroke Risk Linked to Age at First Menstruation?

There may be a link between the age at which a woman begins menstruation and the risk for developing heart disease as well as stroke and high blood pressure, according to a new study.

Led by investigators from the University of Oxford, a research team assessed health data from 1.3 million women in the United Kingdom, between the ages of 50 and 64. The authors monitored the women for more than 10 years, finding that those who had their first menstrual cycle at age 10 or younger, or age 17 or older, were much more likely to develop heart disease, stroke and hypertension-related complications, in comparison to those who had their first menstrual period at age 13.
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Indeed, these women were at 27% higher risk of hospitalization or death from heart disease, were 20% more likely to be hospitalized or die as a result of complications from high blood pressure, and were at 16% greater risk of hospitalization or death resulting from a stroke. According to the authors, these numbers remained consistent even after taking weight, smoking status, and socioeconomic factors into consideration.

Still, the authors point out that their findings are subject to limitations, and note that only 4% of women taking part in the study had their first menstrual cycle at age 10 or younger, and just 1% had their first menstrual cycle at age 17 or later.

The findings “suggest that the timing of the first menstrual cycle could have a long-term influence on women’s vascular health,” says Dexter Canoy, MPhil, MD, PhD, a cardiovascular epidemiologist and researcher in the Cancer Epidemiology Unit at the University of Oxford, and lead author of the study.

Canoy notes, however, that the differences in risks of a vascular disease between single years of menarcheal age are relatively small.

“Since only a small percentage of middle-aged women [were at a] very early (≤10 years) or late age (≥17 years) when their first menstruation started, the risk for developing heart disease or stroke is likely to be small for most middle-aged women,” he says, adding that obesity is particularly common among middle-aged women with early menarche, and reducing excess weight among this group is likely to be beneficial.

“Childhood overweight and obesity are highly prevalent in many industrialized countries, and are closely linked with early age at menarche,” says Canoy. “Strategies to prevent excess weight gain during childhood may also avoid menarche occurring at an earlier age than necessary, which in turn may offer long-term vascular health benefit by reducing the risk of developing heart disease and stroke when they reach middle age.” 

—Mark McGraw

Reference

Canoy D, et al. Age at menarche and risks of coronary heart and other vascular diseases in a large UK cohort. Circulation. 2014.