Each 5-year higher age at menopause was associated with a lower risk of carotid plaque (OR 0.93; 95% CI 0.90-0.95; p<0.001) and reduced carotid intima-media thickness (-3.0 μm; p=0.036).
Meta-Analysis (n=22,249)
Yes
Does later menopause timing reduce subclinical markers of atherosclerosis in postmenopausal women?
Earlier menopause is linked to greater carotid plaque burden and modestly increased cIMT, suggesting menopausal timing is associated with the development of atherosclerosis.
Effect estimate: OR 0.93 (95% CI 0.90-0.95)
p-value: p=<0.001
Abstract Background Menopause represents a pivotal transition in women’s lives and has been strongly linked to cardiovascular health. After menopause, women face a higher likelihood of developing cardiovascular disease (CVD). Beyond menopausal status itself, menopause timing has emerged as an important determinant of cardiovascular risk. Large observational cohort studies consistently report that women who experience menopause at an earlier age have an elevated risk of CVD, coronary heart disease, and stroke. Yet, the biological pathways explaining these associations remain only partially understood. Purpose This study aimed to examine the relationship between menopause timing and subclinical markers of atherosclerosis, specifically carotid intima-media thickness (cIMT) and carotid plaque, to gain insight into the mechanisms connecting menopause timing to cardiovascular health. Methods To clarify these relationships, we conducted an individual participant data meta-analysis of nine cohorts, including 19,827 postmenopausal women from the Prospective Studies of Atherosclerosis (Proof-ATHERO) Consortium, complemented by a systematic review and literature-based meta-analysis of 4 published studies, which contributed data on an additional 2,422 participants. Results Within Proof-ATHERO, the mean baseline age was 61.5 years (standard deviation SD 9.2), and the mean age at menopause was 46.4 years (SD 6.7). Average cIMT was 780 μm (SD 220), and 7,174 women (36%) presented with carotid plaque. Across the pooled analyses, each 5-year higher age at menopause was associated with a lower risk of carotid plaque (odds ratio 0.93, 95% CI 0.90-0.95; p 0.001) and reduced cIMT (-3.0 μm, 95% CI -5.9 to -0.2; p = 0.036). Conclusion In summary, our findings indicate that an earlier menopause is linked to greater carotid plaque burden and modestly increased cIMT, suggesting that menopausal timing is associated with the development of atherosclerosis, a central process in CVD pathogenesis. These results contribute to a deeper understanding of the interplay between reproductive aging and cardiovascular health and underscore the importance of considering sex-specific factors in CVD risk assessment.
Meijs et al. (Mon,) conducted a meta-analysis in Cardiovascular risk in postmenopausal women (n=22,249). Menopause timing (each 5-year higher age at menopause) was evaluated on Carotid plaque (OR 0.93, 95% CI 0.90-0.95, p=<0.001). Each 5-year higher age at menopause was associated with a lower risk of carotid plaque (OR 0.93; 95% CI 0.90-0.95; p<0.001) and reduced carotid intima-media thickness (-3.0 μm; p=0.036).