According to a recent study, women who experience menopause before age 40 are at a significantly higher lifetime risk of coronary heart disease. This risk is especially concerning for Black women, who are three times more likely than white women to face premature menopause.
The connection between this reproductive change and a 40% increase in heart attack risk remains unclear. The study published in JAMA Cardiology did not distinguish between potential causes or signals of risk. However, the researchers stress that premature menopause should be considered in heart disease prevention discussions.
Co-author Priya Freaney, a cardiologist and director of the Women’s Heart Care Program at Northwestern University, emphasized the importance of awareness. She told STAT, “In all individuals who have premature menopause, there’s a ton of potential for raising awareness.” She encourages both patients to discuss it with their doctors to develop prevention plans and clinicians to consider menopause age and related reproductive factors linked to long-term heart disease.
Previously, premature menopause was connected to short-term coronary heart disease in a 2019 JAMA study of female UK Biobank participants over seven years. The new study analyzed data from over 10,000 women across six ongoing studies from 1964 to 2018. Among the 3,522 Black women studied, 15.5% had premature menopause, compared to 4.8% of the 6,514 white women. The study excluded women with surgically induced menopause.
Pradeep Natarajan, director of preventive cardiology at Massachusetts General Hospital, noted the long-term significance of premature menopause. Although not involved in this study, he co-authored the earlier UK Biobank paper. He stated via email to STAT, “This study indicates that having sustained premature menopause is an important lifelong signal, which could be incorporated into cardiovascular risk optimization earlier in life.”
The reasons why Black women experience premature menopause more frequently are not fully understood. However, they have higher rates of early menarche, which is linked to factors like low birth weight, higher childhood weight, and weathering—the cumulative stress from lifelong racial discrimination, poverty, and other social challenges.
Freaney suggests that these disparities result from a mix of social and health factors, calling for more research to address these differences. “This disparity reflects many other disparities we see in heart disease risk factors and heart disease itself in Black versus white women,” she said. “There’s a lot more to be learned about why this is occurring more often in Black women, and then what we can do to mitigate these disparities.”
Menopause generally occurs around age 51. Menopause before 45 is considered early, and before 40 is termed premature. Other reproductive factors influencing heart disease include preeclampsia and gestational diabetes.
The study authors acknowledged that it remains unclear whether premature menopause directly elevates cardiovascular risk or if the associated factors are the primary contributors. However, they assert that the risks can still be addressed.
Early recognition of these risks could lead to improved cardiovascular outcomes.
Natarajan remarked, “This work adds to the growing literature that menopausal history can meaningfully inform cardiovascular disease prevention strategies.”
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.
