Premature Menopause Tied to Increased Risk of Coronary Heart Disease: Study
USA: Researchers have discovered in a new study that early onset of menopause (before age 40) is associated with a higher long-term risk of coronary heart disease. This increased risk is seen across both Black and white women, highlighting the need to include reproductive history as an important factor in cardiovascular risk assessment.
A recent brief report published in JAMA Cardiology by Priya M. Freaney from Northwestern University Feinberg School of Medicine and colleagues provides new insights into the lifetime cardiovascular implications of premature menopause. While earlier studies have linked early menopause to short-term cardiovascular risks, this study focused on its long-term association with coronary heart disease (CHD), including potential differences across racial groups.
The investigators conducted a large, population-based cohort study using pooled individual-level data from six US cohorts. The analysis included postmenopausal women aged 55 to 69 years who were free of CHD at baseline and had documented menopausal history. Women who underwent surgically induced menopause were excluded to ensure a focus on natural menopause. The study spanned several decades, with a follow-up period totaling over 163,000 person-years, enabling a robust evaluation of long-term outcomes.
The researchers reported the following findings:
- The study included 3,522 Black women and 6,514 White women.
- Premature menopause (before age 40) was more common in Black women (15.5%) compared to White women (4.8%).
- Both premature menopause and coronary heart disease incidence were higher overall in Black women.
- The association between premature menopause and lifetime coronary heart disease risk was similar across racial groups.
- Women with premature menopause had about a 40% higher lifetime risk of developing coronary heart disease compared to those without early menopause.
- Hazard ratios were 1.41 for Black women and 1.39 for White women, indicating comparable risk elevation.
The study also assessed the number of years lived free from CHD. Women with premature menopause tended to have fewer CHD-free years compared to those without early menopause. Although these differences did not reach statistical significance, the trend further supports the potential long-term cardiovascular impact of early reproductive aging.
Overall, the findings reinforce premature menopause as an important risk-enhancing factor for coronary heart disease. The authors emphasize that reproductive history should be routinely considered in cardiovascular risk evaluation, particularly in preventive care settings. Identifying women at higher risk earlier in life could help guide timely interventions and tailored strategies to reduce long-term cardiovascular burden.
Reference:
Freaney PM, Ning H, Carnethon M, et al. Premature Menopause and Lifetime Risk of Coronary Heart Disease. JAMA Cardiol. Published online March 18, 2026. doi:10.1001/jamacardio.2026.0212
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