Later-onset menopause linked to lower heart disease risk

Later-onset menopause linked to lower heart disease risk | Image Credit: © Syda Productions - © Syda Productions - stock.adobe.com.

Healthier blood vessels later in life may present in women with later onset menopause, according to a recent study conducted by the University of Colorado Boulder.¹

The trial highlighted a significantly reduced risk of postmenopausal heart attacks and strokes among women with menopause occurring at age 55 years or later. According to study authors, this could lead to new interventions such as dietary therapies to reduce heart disease mortalities in women.¹

“Our paper identifies that there’s actually a physiological benefit to later-onset menopause and is one of the first to identify the specific mechanisms driving these benefits,” said Sanna Darvish, first author and a PhD candidate in the Department of Integrative Physiology. ¹

Heart disease has been reported in nearly half of US women, leading to approximately 1 in 5 deaths in this populations per year. The risk of death from heart disease is lower in the overall female population vs the male population, but their risk is significantly increased after menopause.¹

Data has indicated a potential 20% decrease in heart disease risk from menopause cessation at age 55 years or later vs ages 45 to 54 years. Therefore, investigators conducted a study to determine the impact of late-onset menopause on vascular endothelial dysfunction.²

Participants included age-matched late- and normal-onset postmenopausal women and a reference group including young premenopausal women. Endothelial function was measured in these patients as brachial artery flow-mediated dilation (FMD_BA).²

The change in FMD_BA was assessed in postmenopause women with an acute dose of the mitochondria-targeted antioxidant MitoQ to determine endothelial function. Additional evaluations included serum impact on mitoROS bioactivity of human aortic endothelial cells in all participants.²

Postmenopausal women presented with lower FMD_BA than premenopausal women, but a 50% increase in FMD_BA was reported in those with late-onset menopause vs normal-onset menopause. This indicated a positive correlation between FMD_BA and age at menopause.²

Higher mitoROS bioactivity in human aortic endothelial cells was observed in the serum of normal-onset postmenopausal women vs late-onset postmenopausal women. This indicated a negative correlation between mitoROS bioactivity with FMDBA and age at menopause.²

The data highlighted significantly worse arterial function in postmenopausal women vs premenopausal women.¹ According to researchers, this is because “as people age, they produce less nitric oxide, a compound that helps blood vessels dilate and keeps them from getting stiff and developing plaque.”

Compared to the premenopause group, the late-onset menopause group reported only a 24% worse vascular function, vs the normal-onset group which had 51% worse vascular function. These differences lasted for at least 5 years following menopause onset.¹

Overall, vascular health was 44% worse in the normal-onset group vs the late-onset group. Additionally, improved vascular health was linked to improved mitochondria functioning in the late-onset group, leading to fewer free radicals.¹

The 2 groups also presented with different circulating blood. “More favorable” levels were found for 15 metabolites in the blood of late-onset patients vs early-onset patients.¹

Based on these findings, investigators recommended additional research to determine the factors driving the protection from vascular dysfunction in women with menopause at age 55 years or later. The team intends to conduct a study evaluating the potential impact of early-onset menopause on heart health.¹

“We hope this work puts age at menopause on the map as a female-specific risk factor that women and their doctors discuss more,” said Darvish.¹

References

1. Later-onset menopause linked to healthier blood vessels, lower heart disease risk. University of Colorado at Boulder. February 4, 2025. Accessed February 10, 2025. https://www.eurekalert.org/news-releases/1072647
2. Darvish S, Murray KO, Ludwig KR. Preservation of vascular endothelial function in late-onset postmenopausal women. Circulation Research. 2025. doi:10.1161/CIRCRESAHA.124.325639