A new UC Davis Health study finds that obesity and the age at which women enter menopause may have significant impacts on their heart failure risk.
The study analyzed the elevated risk of heart failure associated with increased BMI (body mass index) and waist circumference among women as they enter menopause. It pointed to the importance of clinicians considering the patient's weight management and reproductive history, including menopause, when evaluating the risk of heart failure.
Heart failure is a serious health condition. It happens when the heart cannot pump enough blood and oxygen to support other organs in the body. High blood pressure, diabetes and obesity are some of the risk factors linked to heart failure.
“It was not clear the influence of age at time of menopause, especially late menopause occurring at age 55 or older, on the risk of heart failure,” said Imo Ebong, associate professor at UC Davis Cardiovascular Medicine and lead investigator of the study. “We know that obesity increases the risk of developing heart failure, and the onset of menopause is linked to increased body fat.”
A woman’s age when she enters menopause is a key factor, and women should share this information with their physicians to guide in estimating their risk of developing heart failure.”
The researchers investigated if and how obesity affects the relationship between menopausal age and the future risk of developing heart failure. They analyzed health data for postmenopausal women participating in the Atherosclerosis Risk in Communities (ARIC) study.
ARIC studies long-term trends in hospitalized heart attack and coronary heart disease deaths. It includes more than 15,000 participants, aged 35 to 84, residing in four diverse communities in North Carolina, Mississippi, Minneapolis and Maryland.
The investigators analyzed data for 4,441 postmenopausal women: (82% with a history of natural menopause and the rest entered menopause due to surgery). The average age was 63.5 years at the time of the survey. There were 903 heart failure events during the follow-up period.
They classified participants into four groups based on their age when they entered menopause: younger than 45 years, 45-49 years, 50-54 years, and 55 years and older.
Results indicated connections between menopausal age, BMI and waist circumference, and heart failure risk. For every six-point increase in BMI, the risk of developing heart failure increased 39% for the women in the menopause-before-age-45 group; 33% for those in the age 45-49 group; and doubled in women in the late menopause group (age 55 or older). Higher BMI was not associated with increased heart failure risk in women who reached menopause between ages 50-54.
We had expected that the effect of obesity on heart failure risk would be greatest among women who had experienced early menopause. This was not the case. The detrimental effects of obesity on heart failure risk were greatest among women who experienced late menopause.”
For every 6-inch increase in waist circumference, the risk of developing heart failure almost tripled among the women who entered menopause at age 55 years or older. Waist circumference did not significantly raise the risk of heart failure for women in any of the other menopausal age groups.
“We had expected that the effect of obesity on heart failure risk would be greatest among women who had experienced early menopause. This was not the case,” Ebong said. “The detrimental effects of obesity on heart failure risk were greatest among women who experienced late menopause.”
Ebong and her fellow investigators plan to continue their research to better understand sex-specific heart failure risk and provide guidance on screening and prevention programs.
“A woman’s age when she enters menopause is a key factor, and women should share this information with their physicians to guide in estimating their risk of developing heart failure,” Ebong said. “Women with early menopause should be informed of their increased risk and counseled to adopt healthy lifestyle and behavioral changes. Women with late menopause should be particularly counseled to maintain a healthy body weight and prevent obesity to decrease their risk of future heart failure.”