Age at menarche and risk of major cardiovascular diseases: Evidence of birth cohort effects from a prospective study of 300,000 Chinese women

Ling Yang; Liming Li; Iona Y. Millwood; Sanne A E Peters; Yiping Chen; Yu Guo; Zheng Bian; Xiaofang Chen; Lingli Chen; Shixian Feng; Silu Lv; Zhigang Pang; Mark Woodward; Zhengming Chen

doi:10.1016/j.ijcard.2016.10.115

Age at menarche and risk of major cardiovascular diseases: Evidence of birth cohort effects from a prospective study of 300,000 Chinese women

Ling Yang, Liming Li, Iona Y. Millwood, Sanne A E Peters, Yiping Chen, Yu Guo, Zheng Bian, Xiaofang Chen, Lingli Chen, Shixian Feng, Silu Lv, Zhigang Pang, Mark Woodward, Zhengming Chen

Bloomberg School of Public Health

Research output: Contribution to journal › Article

Abstract

Background Previous studies of mostly Western women have reported inconsistent findings on the association between age at menarche and risk of cardiovascular disease (CVD). Little is known about the association in China where there has been a large intergenerational decrease in women's mean age at menarche. Methods The China Kadoorie Biobank recruited 302,632 women aged 30–79 (mean 50.5) years in 2004–8 from 10 diverse regional sites across China. During 7 years follow-up, 14,111 incident cases of stroke, 14,093 of coronary heart disease (CHD), and 3200 CVD deaths were reported among 281,491 women who had no prior history of CVD at baseline. Cox regression yielded adjusted hazard ratios (HRs) relating age at menarche to CVD risks. Results The mean (SD) age of menarche was 15.4 (1.9) years, decreasing from 16.2 (2.0) among women born before 1940 to 14.7 (1.6) for those born during the 1960s–1970s. The patterns of association between age at menarche and CVD risk appeared to differ between different birth cohorts, with null associations in older generations but U-shaped or weak positive associations in younger women, especially those born after the 1960s. After minimizing the potential confounding effects from major CVD risk factors, both early and late menarche, compared with menarche at age 13 years, were associated with increased risk of CVD morbidity and mortality, which was more pronounced in younger generations. Conclusion Among Chinese women the associations between age at menarche and risk of CVD differed by birth cohort, suggesting other factors may underpin the association.

Original language	English (US)
Pages (from-to)	497-502
Number of pages	6
Journal	International Journal of Cardiology
Volume	227
DOIs	http://dx.doi.org/10.1016/j.ijcard.2016.10.115
State	Published - Jan 15 2017

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Cohort Effect

Menarche

Cardiovascular Diseases

Prospective Studies

Coronary Disease

Morbidity

Mortality

Keywords

Age at menarche
Birth cohort
Cardiovascular disease
Chinese
Prospective studies

ASJC Scopus subject areas

Medicine(all)
Cardiology and Cardiovascular Medicine

Cite this

Yang, L., Li, L., Millwood, I. Y., Peters, S. A. E., Chen, Y., Guo, Y., ... Chen, Z. (2017). Age at menarche and risk of major cardiovascular diseases: Evidence of birth cohort effects from a prospective study of 300,000 Chinese women. International Journal of Cardiology, 227, 497-502. DOI: 10.1016/j.ijcard.2016.10.115

Age at menarche and risk of major cardiovascular diseases : Evidence of birth cohort effects from a prospective study of 300,000 Chinese women. / Yang, Ling; Li, Liming; Millwood, Iona Y.; Peters, Sanne A E; Chen, Yiping; Guo, Yu; Bian, Zheng; Chen, Xiaofang; Chen, Lingli; Feng, Shixian; Lv, Silu; Pang, Zhigang; Woodward, Mark; Chen, Zhengming.

In: International Journal of Cardiology, Vol. 227, 15.01.2017, p. 497-502.

Research output: Contribution to journal › Article

Yang, L, Li, L, Millwood, IY, Peters, SAE, Chen, Y, Guo, Y, Bian, Z, Chen, X, Chen, L, Feng, S, Lv, S, Pang, Z, Woodward, M & Chen, Z 2017, 'Age at menarche and risk of major cardiovascular diseases: Evidence of birth cohort effects from a prospective study of 300,000 Chinese women' International Journal of Cardiology, vol 227, pp. 497-502. DOI: 10.1016/j.ijcard.2016.10.115

Yang L, Li L, Millwood IY, Peters SAE, Chen Y, Guo Y et al. Age at menarche and risk of major cardiovascular diseases: Evidence of birth cohort effects from a prospective study of 300,000 Chinese women. International Journal of Cardiology. 2017 Jan 15;227:497-502. Available from, DOI: 10.1016/j.ijcard.2016.10.115

Yang, Ling; Li, Liming; Millwood, Iona Y.; Peters, Sanne A E; Chen, Yiping; Guo, Yu; Bian, Zheng; Chen, Xiaofang; Chen, Lingli; Feng, Shixian; Lv, Silu; Pang, Zhigang; Woodward, Mark; Chen, Zhengming / Age at menarche and risk of major cardiovascular diseases : Evidence of birth cohort effects from a prospective study of 300,000 Chinese women.

In: International Journal of Cardiology, Vol. 227, 15.01.2017, p. 497-502.

Research output: Contribution to journal › Article

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title = "Age at menarche and risk of major cardiovascular diseases: Evidence of birth cohort effects from a prospective study of 300,000 Chinese women",

abstract = "Background Previous studies of mostly Western women have reported inconsistent findings on the association between age at menarche and risk of cardiovascular disease (CVD). Little is known about the association in China where there has been a large intergenerational decrease in women's mean age at menarche. Methods The China Kadoorie Biobank recruited 302,632 women aged 30–79 (mean 50.5) years in 2004–8 from 10 diverse regional sites across China. During 7 years follow-up, 14,111 incident cases of stroke, 14,093 of coronary heart disease (CHD), and 3200 CVD deaths were reported among 281,491 women who had no prior history of CVD at baseline. Cox regression yielded adjusted hazard ratios (HRs) relating age at menarche to CVD risks. Results The mean (SD) age of menarche was 15.4 (1.9) years, decreasing from 16.2 (2.0) among women born before 1940 to 14.7 (1.6) for those born during the 1960s–1970s. The patterns of association between age at menarche and CVD risk appeared to differ between different birth cohorts, with null associations in older generations but U-shaped or weak positive associations in younger women, especially those born after the 1960s. After minimizing the potential confounding effects from major CVD risk factors, both early and late menarche, compared with menarche at age 13 years, were associated with increased risk of CVD morbidity and mortality, which was more pronounced in younger generations. Conclusion Among Chinese women the associations between age at menarche and risk of CVD differed by birth cohort, suggesting other factors may underpin the association.",

keywords = "Age at menarche, Birth cohort, Cardiovascular disease, Chinese, Prospective studies",

author = "Ling Yang and Liming Li and Millwood, {Iona Y.} and Peters, {Sanne A E} and Yiping Chen and Yu Guo and Zheng Bian and Xiaofang Chen and Lingli Chen and Shixian Feng and Silu Lv and Zhigang Pang and Mark Woodward and Zhengming Chen",

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AU - Yang,Ling

AU - Li,Liming

AU - Millwood,Iona Y.

AU - Peters,Sanne A E

AU - Chen,Yiping

AU - Guo,Yu

AU - Bian,Zheng

AU - Chen,Xiaofang

AU - Chen,Lingli

AU - Feng,Shixian

AU - Lv,Silu

AU - Pang,Zhigang

AU - Woodward,Mark

AU - Chen,Zhengming

PY - 2017/1/15

Y1 - 2017/1/15

N2 - Background Previous studies of mostly Western women have reported inconsistent findings on the association between age at menarche and risk of cardiovascular disease (CVD). Little is known about the association in China where there has been a large intergenerational decrease in women's mean age at menarche. Methods The China Kadoorie Biobank recruited 302,632 women aged 30–79 (mean 50.5) years in 2004–8 from 10 diverse regional sites across China. During 7 years follow-up, 14,111 incident cases of stroke, 14,093 of coronary heart disease (CHD), and 3200 CVD deaths were reported among 281,491 women who had no prior history of CVD at baseline. Cox regression yielded adjusted hazard ratios (HRs) relating age at menarche to CVD risks. Results The mean (SD) age of menarche was 15.4 (1.9) years, decreasing from 16.2 (2.0) among women born before 1940 to 14.7 (1.6) for those born during the 1960s–1970s. The patterns of association between age at menarche and CVD risk appeared to differ between different birth cohorts, with null associations in older generations but U-shaped or weak positive associations in younger women, especially those born after the 1960s. After minimizing the potential confounding effects from major CVD risk factors, both early and late menarche, compared with menarche at age 13 years, were associated with increased risk of CVD morbidity and mortality, which was more pronounced in younger generations. Conclusion Among Chinese women the associations between age at menarche and risk of CVD differed by birth cohort, suggesting other factors may underpin the association.

AB - Background Previous studies of mostly Western women have reported inconsistent findings on the association between age at menarche and risk of cardiovascular disease (CVD). Little is known about the association in China where there has been a large intergenerational decrease in women's mean age at menarche. Methods The China Kadoorie Biobank recruited 302,632 women aged 30–79 (mean 50.5) years in 2004–8 from 10 diverse regional sites across China. During 7 years follow-up, 14,111 incident cases of stroke, 14,093 of coronary heart disease (CHD), and 3200 CVD deaths were reported among 281,491 women who had no prior history of CVD at baseline. Cox regression yielded adjusted hazard ratios (HRs) relating age at menarche to CVD risks. Results The mean (SD) age of menarche was 15.4 (1.9) years, decreasing from 16.2 (2.0) among women born before 1940 to 14.7 (1.6) for those born during the 1960s–1970s. The patterns of association between age at menarche and CVD risk appeared to differ between different birth cohorts, with null associations in older generations but U-shaped or weak positive associations in younger women, especially those born after the 1960s. After minimizing the potential confounding effects from major CVD risk factors, both early and late menarche, compared with menarche at age 13 years, were associated with increased risk of CVD morbidity and mortality, which was more pronounced in younger generations. Conclusion Among Chinese women the associations between age at menarche and risk of CVD differed by birth cohort, suggesting other factors may underpin the association.

KW - Age at menarche

KW - Birth cohort

KW - Cardiovascular disease

KW - Chinese

KW - Prospective studies

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10.1016/j.ijcard.2016.10.115