November 20, 2017
2 min read

Age at menarche associated with hypertension, obesity risk

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Chinese women who experience late menarche are more likely to develop hypertension in adulthood but less likely to develop obesity vs. women who reach menarche at age 14 to 15 years, according to findings reported in Menopause.

Gang Liu, MD, of the department of cardiology at the First Affiliated Hospital of Chongqing Medical University, China, and colleagues analyzed data from 7,119 women (mean age, 45 years) who participated in a cross-sectional study launched in October 2012 and completed in December 2014 in eight rural districts in Chongqing. Participants underwent physical exams and completed a questionnaire about lifestyle habits, age at menarche and previous medical history. Obesity was defined as BMI of at least 28 kg/m²; abdominal obesity was defined as waist circumference at least 80 cm in women. Hypertension was defined as previously diagnosed with or without treatment, or average systolic BP at least 140 mm Hg and/or diastolic BP of least 90 mm Hg. Researchers stratified women by age at menarche (age 11 years or younger, 12 to 13 years, 14 to 15 years, 16 to 17 years and at least 18 years) and birth cohort (born before 1950, born between 1951-1979 and born after 1980). Researchers used binary logistic regression analysis to assess the association between age at menarche, obesity and hypertension, with ORs computed across menarcheal ages.

Within the cohort, mean age at menarche was 15 years, 38% had obesity, 22% had hypertension, 0.2% had coronary heart disease and 0.1% experienced stroke.

Researchers found that age at menarche was inversely associated with waist circumference (P = .011), but was positively associated with systolic BP (P < .001).

After adjustment for multiple factors, including enrollment age, education level, marital status, lifestyle factors, parity and BP, odds for developing obesity decreased with increasing menarcheal age. Compared with women who reached menarche at age 14 to 15 years, the OR for obesity for women who began menarche at age 11 years or younger was 3.75 (95% CI, 1.35-10.41), followed by 1.15 for women aged 12 to 13 years (95% CI, 0.9-1.48), 0.92 for women aged 16 to 17 years (95% CI, 0.75-1.12) and 0.74 for women aged at least 18 years (95% CI, 0.58-0.96).

In contrast, odds for developing hypertension increase with increasing menarcheal age, according to researchers. After adjustment for BMI and waist circumference, ORs for hypertension ranged from 0.38 for those who reached menarche at age 11 years or younger (95% CI, 0.13-1.08) to 1.39 for those who reached menarche at age 18 years or older (95% CI, 1.08-1.8) vs. women who began menarche at age 14 to 15 years.


After adjustment by birth cohort, researchers found no clearly associated patterns between obesity and menarcheal age and obesity, but the link between age at menarche and hypertension persisted across cohorts.

“Knowledge of age at menarche could function as a critical marker in identifying women at risk of developing CVD, thus enabling them to benefit the most from early preventive interventions, especially in developing countries,” the researchers wrote. – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.