Relationships of Age at Menarche and Menopause, and Reproductive Year with Mortality from Cardiovascular Disease in Japanese Postmenopausal Women: The JACC Study

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  • Cui Renzhe
    Department of Public Health Medicine, Graduate School of Comprehensive Human Science and Institute of Community Medicine, University of Tsukuba.
  • Iso Hiroyasu
    Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine.
  • Toyoshima Hideaki
    Department of Public Health/Health Information Dynamics. Fields of Science, Program of Health and Community Medicine, Nagoya University Graduate School of Medicine.
  • Date Chigusa
    Department of Food Science and Nutrition, Faculty of Human Life and Environment, Nara Women's University.
  • Yamamoto Akio
    Infectious Disease Surveillance Cancer, Infectious Disease Research Division, Hyogo Prefectural Institute of Public Health and Environmental Science.
  • Kikuchi Shogo
    Department of Public Health, Aichi Medical University.
  • Kondo Takaaki
    Department of Public Health/Health Information Dynamics. Fields of Science, Program of Health and Community Medicine, Nagoya University Graduate School of Medicine.
  • Watanabe Yoshiyuki
    Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine Graduate School of Medical Sciences.
  • Koizumi Akio
    Department of Health and Environmental Sciences, Graduate School of Medicine, Kyoto University.
  • Inaba Yutaka
    Department of Epidemiology and Environmental Health, Juntendo University School of Medicine.
  • Tamakoshi Akiko
    Department of Preventive Medicine/Biostatistics and Medical Decision Making, Field of Social Science, Program in Health and Community Medicine, Nagoya University Graduate School of Medicine.

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BACKGROUND: Early menopause is associated with increased risk of coronary heart disease in Caucasian women. However, this association has not been examined in Asian women.<br>METHODS: We conducted a 10-year cohort study of 37,965 Japanese post-menopausal women aged 40-79 years in the Japan Collaborative Cohort (JACC) Study. Causes of death were determined based on the International Classification of Disease.<br>RESULTS: There were 487 mortality of stroke and 178 mortality of coronary heart disease. Late menarche or early menopause, or shorter duration of reproductive period was not associated with risk of mortality from coronary heart disease. However, compared with women with age at menarche ≤13 years, those with age at menarche ≥17 years tended to have increased risk of mortality from stroke: the multivariable hazard ratio was 1.32 (95% confidence interval [CI]: 0.93-1.87, p = 0.10). Compared with women with age at menopause of ≥49 years, those with age at menopause of <49 years tended to have increased risk of coronary heart disease among women aged 40-64 years; the multivariable hazard ratio was 1.85 (95% CI: 0.92-3.73, p = 0.08).<br>CONCLUSIONS: The possible association between early menopause and coronary heart disease among middle-aged women was consistent with the result of observational studies for Caucasian women, and can be explained by a protective effect of endogenous estrogen on the development of atherosclerosis.<br>J Epidemiol 2006; 16: 177-184.

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