Early Menopause may be Linked to Heart Disease Risk

A new review in CMAJ provides guidance for physicians to identify and manage premenopausal women at high risk of heart disease.

Diabetes, metabolic syndrome and smoking were found to be the stronger risk factors for heart disease in younger women, found study.

Deaths from heart disease have decreased in recent decades, but these decreases have not occurred in women //younger than 50. A new review in CMAJ (Canadian Medical Association Journal) provides guidance for physicians to identify and manage premenopausal women at high risk of heart disease.

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In coronary heart disease, blood is unable to flow through blocked arteries. The main symptom is chest pain or angina. Treatment is with medications or surgery.

"Addressing cardiovascular health in women younger than 50 years of age requires thinking 'outside the box' of traditional risk factors in primary prevention," says cardiologist Dr. Beth Abramson, St. Michael's Hospital, and the University of Toronto, Toronto, Ontario, with coauthors.

The review is based on the latest, high-quality evidence published from 2008 to 2018.

Some highlights:

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Younger women with ovarian dysfunction may be at higher risk of cardiovascular disease.

Early menopause because of surgical or chemical interventions may be a risk factor.

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"A challenge in risk assessment is addressing the subpopulation at elevated risk within a lower-risk group," write the authors. "Current risk assessment tools are largely based on age and traditional risk factors and tend to underestimate risk in certain groups of younger women who are at higher risk."

The authors suggest that premenopausal women with these risk factors should be screened early for cardiovascular disease with close follow up and advice on lifestyle modifications where appropriate. Physicians should place more emphasis on sex-specific risk factors in younger women such as preeclampsia and other pregnancy complications, infertility and reproductive technologies.

Identifying higher risk premenopausal women, who have traditionally been considered low risk for future events, is an important step in improving the cardiovascular health of young women. Starting the conversation with these women at risk is the first step in prevention.

Source-Eurekalert