Age at menarche and cardiovascular health: results from the NHANES 1999-2016

Abstract

Objective: Cardiovascular disease is the leading cause of death among women. Early menarche has been associated with many cardiovascular disease risk factors, but little is known about its associations with cardiovascular health (CVH) as defined by Life's Simple 7 (LS7). We aim to examine the associations between age at menarche and CVH.

Methods: Data were obtained from the 1999-2016 National Health and Nutrition Examinations Survey (NHANES). CVH was assessed according to LS7 (ideal CVH: > 4 ideal CVH metrics, CVH score: ranging from 0 to 14). Weighted logistic regression was used after adjusting for sociodemographic factors. The interaction between age at menarche and age was also examined.

Results: Among the 20,447 women included, 2,292 (11.2%) had ideal CVH. After adjusting for age, race/ethnicity, education, poverty income ratio, marital status, and birth year, significantly worse CVH was observed among women with early menarche (OR: 0.70, 95% CI: 0.60-0.82), and higher odds of ideal CVH were observed among those with late menarche (OR: 1.40, 95% CI: 1.21-1.62). Consistent results were observed for CVH score. Age significantly modifies the associations between age at menarche and CVH. Late menarche was significantly associated with ideal CVH among those aged 25-34 (OR: 1.64, 95% CI: 1.27-2.11) or 35-44 (OR: 1.73, 95% CI: 1.31-2.30), while the associations for early menarche were observed only among those aged 25-34 years (OR: 0.72, 95% CI: 0.53-0.97).

Conclusions: Our findings suggested that early menarche is associated with worse CVH, especially among young women. Further efforts are warranted to confirm these findings.