title: Early age at menarche associated with cardiovascular disease and mortality.
abstract: BACKGROUND
  The relationship between age at menarche and cardiovascular disease remains unclear. Two recent studies found an inverse association between age at menarche and all-cause mortality.
  
  
  OBJECTIVE
  The aim of this study was to examine the relationship between age at menarche and cardiovascular disease risk factors, events, and mortality.
  
  
  METHODS
  A population-based prospective study involving 15,807 women, aged 40-79 yr in 1993-1997 and followed up to March 2007 for cardiovascular disease events (median follow-up 10.6 yr) and February 2008 for mortality (median follow-up 12.0 yr) was used.
  
  
  METHODS
  Odds ratios for cardiovascular disease risk factors and hazard ratios for incident cardiovascular disease and mortality were calculated.
  
  
  RESULTS
  There were 3888 incident cardiovascular disease events (1323 coronary heart disease, 602 stroke, and 1963 other) and 1903 deaths (640 cardiovascular disease, 782 cancer, and 481 other) during follow-up. Compared with other women, those who had early menarche (<12 yr) had higher risks of hypertension [1.13 (1.02-1.24)], incident cardiovascular disease [1.17 (1.07-1.27)], incident coronary heart disease [1.23 (1.06-1.43)], all-cause mortality [1.22 (1.07-1.39)], cardiovascular disease mortality [1.28 (1.02-1.62)], and cancer mortality [1.25 (1.03-1.51)], adjusted for age, physical activity, smoking, alcohol, educational level, occupational social class, oral contraceptive use, hormone replacement therapy, parity, body mass index, and waist circumference.
  
  
  CONCLUSIONS
  Early age at menarche (before age 12 yr) was associated with increased risk of cardiovascular disease events, cardiovascular disease mortality, and overall mortality in women, and this association appeared to be only partly mediated by increased adiposity.
authors.affiliation: Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, United Kingdom. rl284@mrc-epid.cam.ac.uk
authors.forename: Rajalakshmi
authors.initials: R
authors.lastname: Lakshman
authors.forename: Nita G
authors.initials: NG
authors.lastname: Forouhi
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Sharp
authors.forename: Robert
authors.initials: R
authors.lastname: Luben
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Bingham
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: Ken K
authors.initials: KK
authors.lastname: Ong
mesh_terms: D050154:Adiposity / Q000502:physiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality*; D002648:Child; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008572:Menarche / Q000502:physiology*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D016017:Odds Ratio; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D055105:Waist Circumference