Age of natural menopause and atrial fibrillation: The Framingham Heart Study
American Heart Journal, 04/02/2012
Magnani JE et al. – In this moderate–sized, community–based sample, authors did not identify menopausal age as significantly increasing atrial fibrillation (AF) risk. However, future larger studies will need to examine whether there is a small effect of menopausal age on AF risk.Methods
- Framingham Heart Study women ≥60 years old without prevalent AF and natural menopause were followed up for 10 years or until incident AF.
- Menopausal age was modeled as a continuous variable and by categories (<45, 45–53, and >53 years).
- Authors used Cox proportional hazards regression to determine associations between menopausal age and AF risk.
- In 1,809 Framingham women (2,662 person–examinations, mean baseline age 71.4 ± 7.6 years, menopausal age 49.8 ± 3.6 years), there were 273 unique participants with incident AF.
- Authors did not identify a significant association between the SD of menopausal age (3.6 years) and AF (hazard ratio [HR] per SD 0.94, 95% CI 0.83–1.06; P = .29).
- In a multivariable model with established risk factors for AF, menopausal age was not associated with incident AF (HR per SD 0.97, 95% CI 0.86–1.09; P = .60).
- Examining categorical menopausal age, earlier menopausal age (<45 years) was not significantly associated with increased AF risk compared with older menopausal age >53 years (HR 1.20, 95% CI 0.74–1.94; P = .52) or menopausal age 45 to 53 years (HR 1.38, 95% CI 0.93–2.04; P = .11).