Premature Menopause and Risk of Cardiovascular Disease: A Meta-Analysis
Aim: The aim of this study was to carry out a meta-analysis to assess the evidence for the association of premature menopause with coronary heart disease, stroke, and total CVD, and to obtain a quantitative estimate of this risk.
Methods: A literature search of observational studies was performed using electronic databases such as Google Scholar, PubMed, JSTOR, etc. Fifteen studies on premature menopause in relation to cardiovascular outcomes were selected. Random-effect model was used to pool relative risk (RR) estimates and corresponding 95% confidence intervals (CI). Between-study heterogeneity was assessed using Cochran’s Q and I2 statistics. Egger’s test, Begg test, and funnel plot asymmetry were used to detect potential publication bias. Sensitivity analysis using the leave-one-out method was performed to examine whether the result was strongly influenced by a specific study. In addition, subgroup analysis was performed for geographical region, study quality, publication year, reference group, and adjustment for potential cofounders. The differences among subgroups were assessed by meta-regression analysis.
Results: The pooled RR estimate for the association between premature menopause and coronary heart disease was 1.871 (95% CI: 0.497-2.338, p < 0.001). The finding of an elevated risk of coronary heart disease was consistently observed in almost all of the stratified analyses. Furthermore, the pooled RR of stroke was 1.433 (95% CI: 1.062-1.934, p = 0.019). The meta-analysis gave a pooled RR of 1.520 (95% CI: 1.198-1.928, p = 0.001), which indicates a 52 percent increase in the risk of overall CVD among women with premature menopause.
Conclusion: The study found an elevated risk of adverse cardiovascular outcomes in women experiencing premature menopause, especially a higher risk of coronary heart disease. This might have significant clinical and public health implications, emphasizing the need for close monitoring of premature menopausal women in clinical practices.
