Objective:

To investigate the relationship between age at menopause, adherence to a healthy lifestyle, and cardiovascular disease (CVD) outcomes in women.

Approach:

• Study Population: Analyzed data from 46,238 women aged 45 years and older from the Sax Institute’s 45 and Up Study in New South Wales.
• Menopause Categorization: Participants were categorized by age at menopause: premature (52 years).
• Outcome Measurement: Primary outcome was self-reported new-onset CVD, including heart disease and stroke, collected through follow-up surveys over 15 years.
• Statistical Analysis: Logistic regression analyses were used to assess the likelihood of CVD based on menopause timing and lifestyle adherence.

Key Findings:

• Women with premature menopause had a 36% higher likelihood of CVD compared to those with median menopause age (OR 1.36, 95% CI 1.17–1.59; p<0.0001).
• Women with early menopause had a 15% higher likelihood of CVD (OR 1.15, 95% CI 1.03–1.28; p=0.013).
• No significant associations were found for relatively early or late menopause groups.
• Women with high lifestyle adherence had 23% lower odds of CVD (OR 0.77, 95% CI 0.68–0.86; p<0.0001).
• Among women with premature menopause, high lifestyle adherence reduced CVD likelihood by 52% (OR 0.48, 95% CI 0.30–0.77; p=0.002).

Interpretation:

Limitations:

• Observational nature of the study and reliance on self-reported data may introduce biases.
• Potential unmeasured confounders and outcome misclassification.
• Attrition bias due to missing data.
• Underpowered interaction analyses limit definitive conclusions.

Conclusion:

Sources:

• Heart Journal