Relationship Between Age at Menopause, Obesity, and Incident Heart Failure: The Atherosclerosis Risk in Communities Study
Year: 2022
Type: article
Abstract: Background The mechanisms linking menopausal age and heart failure (HF) incidence are controversial. We investigated for heterogeneity by obesity on the relationship between menopausal age and HF incidence. Methods and Results Using postmenopausal women who attended the Atherosclerosis Risk in Communities Study Visit 4, we estimated hazard ratios of incident HF associated with menopausal age using Cox proportional hazards models, testing for effect modification by obesity and adjusting for HF risk factors. Women were categorized by menopausal age: <45 years, 45 to 49 years, 50 to 54 years, and ≥55 years. Among 4441 postmenopausal women, aged 63.5±5.5 years, there were 903 incident HF events over a mean follow‐up of 16.5 years. The attributable risk of generalized and central obesity for HF incidence was greatest among women who experienced menopause at age ≥55 years: 11.09/1000 person‐years and 7.38/1000 person‐years, respectively. There were significant interactions of menopausal age with body mass index and waist circumference for HF incidence, P interaction 0.02 and 0.001, respectively. The hazard ratios of incident HF for a SD increase in body mass index was elevated in women with menopausal age <45 years [1.39 (1.05–1.84)]; 45–49 years [1.33, (1.06–1.67)]; and ≥55 years [2.02, (1.41–2.89)]. The hazard ratio of incident HF for a SD increase in waist circumference was elevated only in women with menopausal age ≥55 years [2.93, (1.85–4.65)]. Conclusions As obesity worsened, the risk of developing HF became significantly greater when compared with women with lower body mass index and waist circumference, particularly among those who had experienced menopause at age ≥55 years.
Institutions: University of California Davis Medical Center, University of California, Davis, Texas Tech University, Texas Tech University Health Sciences Center, Johns Hopkins University, Johns Hopkins Medicine, Washington University in St. Louis, University of Arizona, University of Minnesota, Vanderbilt University, University of California, Los Angeles, University of North Carolina at Chapel Hill, Wake Forest University Health Sciences, Wake Forest University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,700
Awards: G1114307781, G151374072, G156123175, G2400182239, G3848509074, G3973572274, Seeking Objectivity in Allocation of Advanced Heart Failure (SOCIAL HF) Therapies Trial, G4790942633, G5770678025, G6837735701, G76050909, G8738262636, UC Davis Clinical and Translational Science Center, Washington University Nutrition Obesity Research Center, PRIDE Summer Institute in Cardiovascular Disease Comorbidities, Genetics and Epidemiology (CVD-CGE)
OpenAlex ID: W4223467313