Association between early menopause and late-life anxiety symptoms among community-dwelling hypertensive women

• This study examines the association between early menopause and late-life anxiety symptoms in older women with hypertension. • After matching for potential confounding variables, the prevalence of anxiety was 10.75 percentage points higher (at 31.23%) in community-dwelling older hypertensive women with early menopause compared with those without early menopause (20.48%). • This study highlights the importance of focusing on the association between menopause status and late-life mental health. This study examines the association between early menopause and late-life anxiety symptoms in older women with hypertension. After matching for potential confounding variables, the prevalence of anxiety was 10.75 percentage points higher (at 31.23%) in community-dwelling older hypertensive women with early menopause compared with those without early menopause (20.48%). This study highlights the importance of focusing on the association between menopause status and late-life mental health. Early menopause has long-term influence on women's health. This study investigated the relationship between early menopause and late-life anxiety symptoms in community-dwelling hypertensive women. This cross-sectional study included community-dwelling older hypertensive women. The on-site investigation was conducted in 2023 in Pingdingshan City in central China, and participants were included using cluster random sampling. The primary variables were early menopause (at the age of 40–44 years) and anxiety symptoms (as rated on the 7-item Generalized Anxiety Disorder scale). Covariates included general information, women's health, health status, and lifestyle. Univariable analysis and multivariable hierarchical logistic regression were used to investigate the factors associated with anxiety symptoms. Propensity score matching (PSM) was performed to investigate the association between early menopause and anxiety symptoms. A total of 4933 participants were included. The prevalence of anxiety symptoms was 21.20% (95% CI 20.06%, 22.34%) and that of early menopause 11.88% (95% CI 10.98%, 12.78%). Anxiety symptoms were significantly associated with early menopause after multivariable adjustment (aOR = 2.041, 95%CI 1.627, 2.559; prevalence ratio = 1.57). The following variables were identified as factors associated with anxiety symptoms ( P < 0.05) and included in the PSM covariate set: age, cardiovascular diseases, neurological diseases, depressive symptoms, difficulty grooming or dressing, pain or discomfort, score on the Pittsburgh Sleep Quality Index, frequency of outdoor activities, and frequency of reading. After PSM, 586 pairs of patients showed no covariate differences. There was a 10.75% difference in anxiety symptoms between participants with early and normal menopause [(31.23%, 183/586) vs. (20.48%, 120/586), P < 0.001, risk ratio = 1.53]. Early menopause is significantly associated with late-life anxiety symptoms in hypertensive women in Central China.