Women who enter menopause before age 40 (premature menopause) have a significantly higher risk of developing coronary heart disease compared to women who experience menopause later in life, according to a new study led by Priya M. Freaney, assistant professor of medicine in the division of cardiology at Northwestern University’s Feinberg School of Medicine.
Dr. Freaney and her co-authors examined data on a large group of women who participated in six long-term studies in the United States from 1964 to 2018. Over that time period, the participant sample experienced more than 1,000 cases of coronary heart disease events.
After controlling for other cardiovascular risk factors such as smoking, obesity, hypertension, and diabetes, premature menopause was associated with a 40 percent higher risk of heart disease.
“As the natural estrogen declines, no matter what age it happens in, cholesterol and blood pressure go up, body fat distribution shifts to the abdomen, muscle mass gets lower, blood sugars can become dysregulated, and arteries stiffen,” said Dr. Freaney. “Together, these changes over a short period increase the risk of heart disease.”
Based on these findings, the authors suggest women who experience premature menopause should consider it an early signal to take their heart health seriously. They also encourage physicians to regularly ask women about age at menopause in order to identify higher-risk patients and intervene earlier.
At Northwestern Medicine, Dr. Freaney serves as director of the Women’s Heart Care Program in the Bluhm Cardiovascular Institute. In addition to premature menopause, she studies other sex-specific risk factors for heart disease in women, such as pre-eclampsia. Dr. Freaney earned her bachelor’s degree from Duke University in Durham, North Carolina, and her medical degree from Ohio State University.