title: The influence of early menopause on cardiovascular risk in women with rheumatoid arthritis.
abstract: OBJECTIVE
  Early menopause is associated with an increased risk for developing rheumatoid arthritis (RA). The risk for cardiovascular disease (CVD) in women increases following menopause. Because RA is associated with an increased risk of CVD, this study was undertaken to determine whether early menopause affects the risk of developing CVD in women with RA.
  
  
  METHODS
  A population-based inception cohort of 600 women with RA who fulfilled 1987 American College of Rheumatology criteria for RA between 1955 and 2007 and were age ≥ 45 years at diagnosis was assembled and followed. Age at menopause and duration of hormone replacement therapy, along with occurrence of CVD, was ascertained by review of medical records. Cox proportional hazard models compared women who underwent early menopause (natural or artificial menopause at age ≤ 45 yrs) to those within the cohort who did not undergo early menopause.
  
  
  RESULTS
  Of 600 women, 79 experienced early menopause. Women who underwent early menopause were at significantly higher risk for developing CVD when compared to women who did not (HR 1.56; 95% CI 1.08-2.26).
  
  
  CONCLUSIONS
  The risk of CVD in women with RA was higher in those who experienced early menopause, and like other known risk factors should increase clinician concern for development of CVD in these patients.
authors.affiliation: From the Division of Biomedical Statistics and Informatics and the Division of Epidemiology, Department of Health Sciences Research, and the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.E.C. Pfeifer, MD, Department of Internal Medicine; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, and Division of Rheumatology; S. Amin, MD, MPH; S.E. Gabriel, MD, MSc; E.L. Matteson, MD, MPH, Division of Rheumatology and Division of Epidemiology, Mayo Clinic.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Pfeifer
authors.affiliation: From the Division of Biomedical Statistics and Informatics and the Division of Epidemiology, Department of Health Sciences Research, and the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.E.C. Pfeifer, MD, Department of Internal Medicine; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, and Division of Rheumatology; S. Amin, MD, MPH; S.E. Gabriel, MD, MSc; E.L. Matteson, MD, MPH, Division of Rheumatology and Division of Epidemiology, Mayo Clinic.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Crowson
authors.affiliation: From the Division of Biomedical Statistics and Informatics and the Division of Epidemiology, Department of Health Sciences Research, and the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.E.C. Pfeifer, MD, Department of Internal Medicine; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, and Division of Rheumatology; S. Amin, MD, MPH; S.E. Gabriel, MD, MSc; E.L. Matteson, MD, MPH, Division of Rheumatology and Division of Epidemiology, Mayo Clinic.
authors.forename: Shreyasee
authors.initials: S
authors.lastname: Amin
authors.affiliation: From the Division of Biomedical Statistics and Informatics and the Division of Epidemiology, Department of Health Sciences Research, and the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.E.C. Pfeifer, MD, Department of Internal Medicine; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, and Division of Rheumatology; S. Amin, MD, MPH; S.E. Gabriel, MD, MSc; E.L. Matteson, MD, MPH, Division of Rheumatology and Division of Epidemiology, Mayo Clinic.
authors.forename: Sherine E
authors.initials: SE
authors.lastname: Gabriel
authors.affiliation: From the Division of Biomedical Statistics and Informatics and the Division of Epidemiology, Department of Health Sciences Research, and the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.E.C. Pfeifer, MD, Department of Internal Medicine; C.S. Crowson, MS, Division of Biomedical Statistics and Informatics, and Division of Rheumatology; S. Amin, MD, MPH; S.E. Gabriel, MD, MSc; E.L. Matteson, MD, MPH, Division of Rheumatology and Division of Epidemiology, Mayo Clinic. matteson.eric@mayo.edu.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Matteson
mesh_terms: D000367:Age Factors; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D012307:Risk Factors
keywords: CARDIOVASCULAR DISEASE; MENOPAUSE; RHEUMATOID ARTHRITIS