title: Ascending Aortic Disease is Associated with Earlier Menopause and Shorter Reproductive Life Span.
abstract: The incidence of cardiovascular morbidity and mortality in premenopausal women is comparatively low, but increases sharply after menopause. The principal aim of this study was to determine whether women with ascending aortic disease (AAD) have a different reproductive history from that of an age-matched control group.
  
  
  
  In this retrospective study, women who had undergone ascending aortic aneurysm (AscAA) repair between 2000 and 2010 were asked to complete a questionnaire concerning risk factors and reproductive history. Data from 142 women with AAD were evaluated, and a subgroup (n = 64) with AscAA ≥5 cm was analyzed and compared to an age-matched random control group without known aortic diseases.
  
  
  
  Almost all women were menopausal at the time of the questionnaire (98.4% vs. 90.6%, AscAA ≥5 cm subcohort vs. control, p = 0.12) and all subjects presented with a comparable age of menarche (13.7 ± 2.6 years vs. 14.2 ± 1.8 years, AscAA ≥5 cm subcohort vs. control, log-rank 0.04, p = 0.84). However, mean menopausal age was significantly lower in the case subcohort than in controls (48.1 ± 4.8 years vs. 50.6 ± 5.8 years, AscAA ≥5 cm subcohort vs. control, log-rank 8.35, p = 0.004), and reproductive life span was correspondingly shorter (34.2 ± 5.2 years vs. 36.2 ± 5.7 years, p = 0.04). Furthermore, hypertension was more prevalent in women with AscAA ≥5 cm compared to controls (89.1% vs. 61.9%, AscAA ≥5 cm subcohort vs. control, p < 0.001).
  
  
  
  Women who experience menopause at an earlier age than the regional mean could profit from screening for cardiovascular disease in general and particularly for AAD. Screening would enable early aneurysm detection and could, therefore, reduce morbidity and mortality.
authors.affiliation: 1 Department of Cardiac Surgery, Ludwig-Maximilians-Universität München , Munich, Germany .|2 Department of Anaesthesiology, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Verena
authors.initials: V
authors.lastname: Schuster
authors.affiliation: 3 Department of Obstetrics and Gynaecology, Ludwig-Maximilians-Universität München , Munich, Germany .|4 Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Tanja K
authors.initials: TK
authors.lastname: Eggersmann
authors.affiliation: 1 Department of Cardiac Surgery, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Sandra
authors.initials: S
authors.lastname: Eifert
authors.affiliation: 1 Department of Cardiac Surgery, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Peter
authors.initials: P
authors.lastname: Ueberfuhr
authors.affiliation: 1 Department of Cardiac Surgery, Ludwig-Maximilians-Universität München , Munich, Germany .|4 Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Brita
authors.initials: B
authors.lastname: Zugenmaier
authors.affiliation: 3 Department of Obstetrics and Gynaecology, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Kolben
authors.affiliation: 3 Department of Obstetrics and Gynaecology, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Thaler
authors.affiliation: 5 Department of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University , Stockholm, Sweden .
authors.forename: Karolina
authors.initials: K
authors.lastname: Kublickiene
authors.affiliation: 6 Institute for Medical Information Sciences, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Anna
authors.initials: A
authors.lastname: Rieger
authors.affiliation: 4 Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Bruno
authors.initials: B
authors.lastname: Reichart
authors.affiliation: 1 Department of Cardiac Surgery, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Christian
authors.initials: C
authors.lastname: Hagl
authors.affiliation: 1 Department of Cardiac Surgery, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Maximilian A
authors.initials: MA
authors.lastname: Pichlmaier
authors.affiliation: 1 Department of Cardiac Surgery, Ludwig-Maximilians-Universität München , Munich, Germany .|4 Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität München , Munich, Germany .
authors.forename: Sonja
authors.initials: S
authors.lastname: Guethoff
mesh_terms: D000367:Age Factors; D000368:Aged; D001018:Aortic Diseases / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D005858:Germany; D006801:Humans; D008572:Menarche; D008593:Menopause; D008875:Middle Aged; D017584:Reproductive History; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires