BOSTON — Younger age at menopause was independently associated with decreased risk for atrial fibrillation, according to new data from the Women’s Health Study.
“Our findings present a possible pathophysiological link between duration of exposure to estrogen and AF in women,” Jorge A. Wong, MD, and colleagues wrote in an abstract presented at the Heart Rhythm Society Annual Scientific Sessions.
Although early menopausal age has been associated with increased risk for CVD, including stroke, the relationship between early menopausal age and AF risk was unclear, according to Wong and colleagues. The researchers analyzed 17,932 participants from the Women’s Health Study who were older than 45 years, postmenopausal, had not undergone hysterectomy without bilateral oophorectomy before menopause, and were free of CVD and AF at baseline. Median age at baseline was 58 years and median age of reported menopause was 48 years.
The primary outcome was development of new-onset AF, confirmed by medical record review. Participants were stratified by age at menopause: younger than 44 years, 44 to 50 years or older than 50 years.
During a median follow-up of 19.1 years, 986 women developed incident AF.
In a multivariable analysis, compared with women who reported menopause at age 44 to 50 years, women who reported menopause at an age younger than 44 years had a lower risk for AF (adjusted HR = 0.83; 95% CI, 0.7-0.99). Adjustment for surgical or chemotherapy-induced menopause did not change the results (HR for age younger than 44 years = 0.82; 95% CI, 0.68-0.98).
Wong and colleagues found no significant relationship between age at menopause older than 50 years and AF risk (adjusted HR = 0.91; 95% CI, 0.77-1.06).
“In this study, we found that earlier age at menopause was associated with a decreased risk of incident AF,” Wong, a postdoctoral fellow at Brigham and Women’s Hospital, said in a press release. “This is in contrast with the relationship we see between early menopause and [CHD] and stroke, where earlier age at menopause has been associated with elevations in risk. The results provide insight into the complicated and often divergent pathways leading to AF and heart disease in women.” – by Erik Swain
Wong JA, et al. Abstract AB33-01. Presented at: Heart Rhythm Society Annual Scientific Sessions; May 13-16, 2015; Boston.
Disclosure: Wong reports no relevant financial disclosures.