Abstract：
OBJECTIVE: 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.
METHODS: 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 I2 statistic was employed to assess heterogeneity, and the Egger\'s test was used to determine publication bias.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 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 I2 statistic was employed to assess heterogeneity, and the Egger\'s test was used to determine publication bias.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
目的：更年期与心血管疾病的高风险有关。然而,尚不清楚过早绝经(定义为40岁之前绝经)或过早绝经(定义为45岁之前绝经)是否与心力衰竭或心房颤动风险增加相关.这项研究旨在检查有关绝经早期与心力衰竭和心房颤动风险之间关系的最可靠证据。
方法：在三个在线数据库中进行了全面的文献检索，Embase,WebofScience,和PubMed,从数据库建立到2023年4月1日。结果表示为具有95%置信区间的风险比。I2统计量用于评估异质性，并使用Egger检验来确定发表偏倚。
结果：九项队列研究被纳入分析，共有6,255,783名绝经后妇女。与45岁后绝经的女性相比，过早绝经和早绝经的女性发生心力衰竭的风险增加（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）。亚组分析显示,与绝经早期相比，过早绝经与心力衰竭和心房颤动的风险增加有更强的关联。
结论：与正常年龄范围内绝经的女性相比，绝经提前或提前绝经的女性发生心力衰竭和心房颤动的风险更高。需要考虑这些生殖因素，以采取可能降低心力衰竭和心房颤动风险的措施。
方法：在三个在线数据库中进行了全面的文献检索，Embase,WebofScience,和PubMed,从数据库建立到2023年4月1日。结果表示为具有95%置信区间的风险比。I2统计量用于评估异质性，并使用Egger检验来确定发表偏倚。
结果：九项队列研究被纳入分析，共有6,255,783名绝经后妇女。与45岁后绝经的女性相比，过早绝经和早绝经的女性发生心力衰竭的风险增加（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）。亚组分析显示,与绝经早期相比，过早绝经与心力衰竭和心房颤动的风险增加有更强的关联。
结论：与正常年龄范围内绝经的女性相比，绝经提前或提前绝经的女性发生心力衰竭和心房颤动的风险更高。需要考虑这些生殖因素，以采取可能降低心力衰竭和心房颤动风险的措施。
