Key result
Among women aged ≥65 years, premature menopause (age <40 years) was associated with a 21% higher risk of incident atrial fibrillation (HR 1.21), while number of live births was not.
Why the study?
Female reproductive factors have been associated with cardiovascular disease risk, but their role in AF is underexplored, particularly in older adults.
Does earlier menopausal age or a higher number of live births increase the risk of incident atrial fibrillation in older women?
Cohort (n=3,236)
Yes
Does earlier menopausal age or a higher number of live births increase the risk of incident atrial fibrillation in older women?
Earlier age at menopause, but not number of live births, is independently associated with an increased risk of atrial fibrillation and adverse atrial remodeling markers in older women.
Background Female reproductive factors including menopausal age and number of live births have been associated with cardiovascular disease risk, but their role in atrial fibrillation (AF) is underexplored, especially in older adults. Methods We analyzed data from the CHS (Cardiovascular Health Study), a US population‐based longitudinal study of adults aged ≥65 years including 3065 women reporting their menopausal age and 3236 reporting number of live births at participation. We followed participants for incident AF until June 2015. NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) was measured at baseline. Maximal P‐wave duration, P‐wave terminal force in V 1 , and P‐wave dispersion were calculated from baseline ECGs. We assessed the associations of menopausal age, number of live births, and NT‐proBNP and electrocardiographic findings with incident AF using linear regression and a Cox model. Results After a median follow‐up of 7.5 years, 1266 women (41.3%) developed AF. Each 5‐year increase in menopausal age was associated with lower AF risk (hazard ratio [HR], 0.96 [95% CI, 0.92–1.00]). Menopausal age <40 years was associated with higher AF risk (HR, 1.21 [95% CI, 1.02–1.44]). No association was found between the number of live births and AF risk (HR, 0.98 [95% CI, 0.95–1.02]). Cross‐sectional analyses showed younger menopausal age was associated with higher NT‐proBNP levels, longer maximal P‐wave duration, and longer P‐wave dispersion. Conclusions Among women aged ≥65 years, earlier menopausal age was associated with higher NT‐proBNP, longer P‐wave duration, longer P‐wave dispersion, and higher AF risk. Number of live births was not associated with these end points.
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Morooka et al. (2026) conducted a cohort in Atrial Fibrillation (n=3,236). Premature menopause (menopausal age <40 years) vs. Menopausal age ≥45 years was evaluated on Incident atrial fibrillation (HR 1.21, 95% CI 1.02-1.44). Among women aged ≥65 years, premature menopause (age <40 years) was associated with a 21% higher risk of incident atrial fibrillation (HR 1.21), while number of live births was not.
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