title: Age at menarche, total mortality and mortality from ischaemic heart disease and stroke: the Adventist Health Study, 1976-88.
abstract: BACKGROUND
  Little is known about the relationship between age at menarche and total mortality and mortality from ischaemic heart disease and stroke.
  
  
  METHODS
  A cohort study of 19 462 Californian Seventh-Day Adventist women followed-up from 1976 to 1988. A total of 3313 deaths occurred during follow-up, of which 809 were due to ischaemic heart disease and 378 due to stroke.
  
  
  RESULTS
  An early menarche was associated with increased total mortality (P-value for linear trend <0.001), ischaemic heart disease (P-value for linear trend = 0.01) and stroke (P-value for linear trend = 0.02) mortality. There were, however, also some indications of an increased ischaemic heart disease mortality in women aged 16-18 at menarche (5% of the women). When assessed as a linear relationship, a 1-year delay in menarche was associated with 4.5% (95% CI 2.3-6.7) lower total mortality. The association was stronger for ischaemic heart disease [6.0% (95% CI 1.2-10.6)] and stroke [8.6% (95% CI 1.6-15.1)] mortality.
  
  
  CONCLUSIONS
  The results suggest that there is a linear, inverse relationship between age at menarche and total mortality as well as with ischaemic heart disease and stroke mortality.
authors.affiliation: Institute of Community Medicine, University of Tromsø, Tromsø, N-9037 Tromsø, Norway. bjarne.jacobsen@ism.uit.no
authors.forename: B K
authors.initials: BK
authors.lastname: Jacobsen
authors.forename: K
authors.initials: K
authors.lastname: Oda
authors.forename: S F
authors.initials: SF
authors.lastname: Knutsen
authors.forename: G E
authors.initials: GE
authors.lastname: Fraser
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002140:California / Q000453:epidemiology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008423:Maternal Age; D008572:Menarche; D008875:Middle Aged; D009026:Mortality; D017202:Myocardial Ischemia / Q000401:mortality; D020521:Stroke / Q000401:mortality