PDF(Pubmed)
Abstract：
Background Mortality from cardiovascular diseases in Asian populations is considerable. Menopause is a risk-enhancing factor for cardiovascular disease, but it is unclear whether menopause is an independent risk factor for cardiovascular disease and mortality in Asian women. Methods and Results A total of 1 159 405 postmenopausal women, who had participated in the health examinations of the Korean National Health Insurance Service in 2009, were analyzed, and their reproductive histories were taken. A multivariable Cox proportional hazard model assessed the hazard ratios (HRs) of myocardial infarction (MI), ischemic stroke, and all-cause mortality, according to the history of premature menopause and age at menopause. After an average 10-year follow-up, there were 31 606, 45 052, and 77 680 new cases of MI, ischemic stroke, and all-cause mortality, respectively. The women with premature menopause exhibited increased risks of MI (HR, 1.40 [95% CI, 1.31-1.50]), ischemic stroke (HR, 1.24 [95% CI, 1.17-1.31]), and all-cause mortality (HR, 1.19 [95% CI, 1.14-1.24]) when compared with women with menopause aged ≥50 years. The highest risk was evident with menopause between the ages of 30 and 34 years (HR for MI, 1.52 [95% CI, 1.30-1.78]; HR for ischemic stroke, 1.29 [95% CI, 1.12-1.48]; HR for all-cause mortality, 1.33 [95% CI, 1.20-1.47]) when compared with women with menopause aged ≥50 years. Conclusions Earlier age at menopause was associated with increased risks for MI, ischemic stroke, and all-cause mortality. Future guidelines and risk assessment tools should consider menopause as an independent risk factor of cardiovascular disease in Korean women.
摘要：
背景：亚洲人群心血管疾病死亡率相当高。更年期是心血管疾病的风险增加因素，但目前尚不清楚绝经是否是亚洲女性心血管疾病和死亡率的独立危险因素.方法与结果共1159405例绝经后妇女,2009年参加韩国国民健康保险服务的健康检查，并记录了他们的生殖史。多变量Cox比例风险模型评估了心肌梗死（MI）的风险比（HR），缺血性卒中,和全因死亡率，根据绝经史及绝经年龄。经过平均10年的随访，有31,606,45,052和77,680例新的MI，缺血性卒中,和全因死亡率，分别。过早绝经的女性表现出MI的风险增加(HR，1.40[95%CI，1.31-1.50])，缺血性卒中（HR，1.24[95%CI，1.17-1.31])，和全因死亡率(HR，1.19[95％CI，1.14-1.24]）与绝经年龄≥50岁的女性相比。在30岁至34岁之间的绝经风险最高（MI的HR，1.52[95%CI，1.30-1.78]；缺血性卒中的HR，1.29[95%CI，1.12-1.48]；全因死亡率的HR，1.33[95％CI，1.20-1.47]）与绝经年龄≥50岁的女性相比。结论绝经年龄较早与MI风险增加有关。缺血性卒中,和全因死亡率。未来的指南和风险评估工具应将绝经视为韩国女性心血管疾病的独立危险因素。
