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J Clin Epidemiol. 1999 Apr;52(4):303-7.

Age at natural menopause and total mortality and mortality from ischemic heart disease: the Adventist Health Study.

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Center for Health Research and Department of Epidemiology and Biostatistics, School of Public Health, Loma Linda University, California, USA.


We studied the relationship between age at natural menopause and total mortality as well as mortality from ischemic heart disease in a cohort of 6182 California Seventh-Day Adventist women who reported a natural menopause. During follow-up from 1976 through 1988, there were 1831 deaths. A total of 308 deaths due to ischemic heart disease occurred in women who denied ischemic heart disease at start of follow-up. An early menopause was associated with increased total mortality (P value for linear trend <0.001) and ischemic heart disease mortality (P value for linear trend = 0.03). This relationship could not be explained by possible confounding variables. Our results support the hypothesis that an early natural menopause (35-40 years old) increases the risk of ischemic heart disease. There is, however, also some evidence of increased risk of ischemic heart disease in women with a very late menopause (>55 years), particularly in women who never have used postmenopausal estrogens.

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