First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
School of Traditional Chinese Medicine, Jinan University, Guangzhou, China.
Maturitas. 2023 Oct;176:107784. doi: 10.1016/j.maturitas.2023.107784. Epub 2023 Jun 7.
Menopause is linked to a higher risk of cardiovascular disease. However, it is unclear whether premature menopause (defined as menopause before the age of 40 years) or early menopause (defined as menopause before the age of 45 years) is associated with an increased risk of heart failure or atrial fibrillation. This study aimed to examine the most reliable evidence on the relationship between early menopause and the risk of heart failure and atrial fibrillation.
A comprehensive literature search was performed in three online databases, Embase, Web of Science, and PubMed, from database establishment to April 1, 2023. The results were presented as hazard ratios with 95 % confidence intervals. The I statistic was employed to assess heterogeneity, and the Egger's test was used to determine publication bias.
Nine cohort studies were included in the analysis, with a total of 6,255,783 postmenopausal women. Women with premature and early menopause had an increased risk of heart failure (HR: 1.39, 95 % CI: 1.31-1.47; HR: 1.23, 95 % CI: 1.10-1.37, respectively) and atrial fibrillation (HR: 1.15, 95 % CI: 1.01-1.31; HR: 1.08, 95 % CI: 1.04-1.13, respectively) when compared with women who had undergone menopause after the age of 45 years. Subgroup analysis showed that, compared with early menopause, premature menopause has a stronger association with an increased risk of heart failure and atrial fibrillation.
Women who undergo premature menopause or early menopause have a higher risk of heart failure and atrial fibrillation compared with women who undergo menopause in the normal age range. These reproductive factors need to be considered for measures that might reduce the risk of heart failure and atrial fibrillation.
绝经与心血管疾病风险增加有关。然而，目前尚不清楚绝经提前（定义为 40 岁以前绝经）或绝经早（定义为 45 岁以前绝经）是否与心力衰竭或心房颤动风险增加相关。本研究旨在探讨绝经提前与心力衰竭和心房颤动风险之间关系的最可靠证据。
从数据库建立到 2023 年 4 月 1 日，我们在 Embase、Web of Science 和 PubMed 这三个在线数据库中进行了全面的文献检索。结果以 95%置信区间的风险比表示。采用 I ² 统计量评估异质性，采用 Egger 检验评估发表偏倚。
共纳入 9 项队列研究，共纳入 6255783 名绝经后女性。与 45 岁以后绝经的女性相比，绝经提前和绝经早的女性发生心力衰竭（HR：1.39，95%CI：1.31-1.47；HR：1.23，95%CI：1.10-1.37）和心房颤动（HR：1.15，95%CI：1.01-1.31；HR：1.08，95%CI：1.04-1.13）的风险均增加。亚组分析显示，与绝经早相比，绝经提前与心力衰竭和心房颤动风险增加的相关性更强。
与绝经年龄正常的女性相比，绝经提前或绝经早的女性发生心力衰竭和心房颤动的风险更高。这些生殖因素需要考虑在内，以采取可能降低心力衰竭和心房颤动风险的措施。
