Age at period cessation and trajectories of cardiovascular risk factors across mid and later life: a prospective cohort study

Summary What is already known about this topic Age at period cessation is associated with cardiovascular disease. Whether age at period cessation adversely affects change in conventional cardiovascular intermediates from mid to later life is not well understood. What this study adds Women and clinicians concerned about the impact of type and timing of period cessation on conventional cardiovascular intermediates from midlife should be reassured that the impacts over the long term are small. Objective To examine the association between age at period cessation (by type of period cessation) and trajectories of anthropometry, blood pressure, lipids and HBA1c from midlife. Design Prospective cohort study of women recruited to the Medical Research Council National Survey of Health and Development (NSHD). Setting Population based prospective cohort study. Participants Women participating in NSHD with a known date of period cessation and at least one measure of each intermediate cardiovascular risk factor. Exposures Age at period cessation and type of period cessation (hysterectomy compared with natural menopause). Outcomes Repeated measures of systolic blood pressure, diastolic blood pressure, body mass index (BMI) and waist circumference (WC) from 36 to 69 years and repeated measures of triglyceride, low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c) and glycated haemoglobin (HBA1c) from 53 to 69 years. Results We found no evidence that age at period cessation was associated with trajectories of log triglyceride, LDL-c and HDL-c from 53 to 69 years and trajectories of blood pressure from 36 to 69 years, regardless of whether period cessation occurred naturally or due to hysterectomy. While we found some evidence of associations of age at period cessation with log BMI, log WC and log HBA1C, patterns were not consistent and differences were small at age 69 years, with confidence intervals that spanned the null. For instance, the difference in log WC at age 69 per year increase in age at natural menopause was 0.003 (95% confidence interval, −0.0002, 0.01) while the difference per year increase in age at hysterectomy was −0.002 (95% CI, −0.005, 0.001). Conclusion How and when women experience period cessation is unlikely to adversely affect conventional cardiovascular risk factors across mid and later life. Women and clinicians concerned about the impact of type and timing of period cessation on conventional cardiovascular intermediates from midlife should be reassured that the impacts over the long term are small.