Women who started their period before the age of 12 may have a heightened risk of cardiovascular disease and stroke in later life, a study has found.
Experiencing an early menopause, pregnancy complications and having a hysterectomy were also linked to an increased risk of the disease, the research published in the journal Heart revealed.
Responding to the study’s findings, Christopher Allen, senior cardiac nurse at the British Heart Foundation, said further research is needed to understand why this link exists.
He also urged women to look after their heart health and take advantage of free NHS health checks where possible.
Cardiovascular disease (CVD) is an umbrella term for all the diseases of the heart and circulation including coronary heart disease, angina, heart attack, congenital heart disease and stroke.
Coronary heart disease and stroke can be caused by the same problem – atherosclerosis, where the arteries become narrowed by a gradual build-up of fatty material.
According to the BHF, coronary heart disease kills more than twice as many women as breast cancer in the UK.
Previous research has suggested that certain reproductive risk factors may be linked to an increased risk of heart disease or stroke, but the findings have drawn mixed results.
In a bid to clarify any potential associations, researchers analysed data from the UK Biobank, a large population based study of more than half a million men and women up to the age of 69, who had been recruited between 2006 and 2010.
Participants filled in questionnaires on their lifestyle, environment and medical history, which included a wide range of reproductive factors. They also took tests to assess their physical and functional health, and provided urine, blood, and saliva samples.
The health of 267,440 women and 215,088 men - none of whom had cardiovascular disease when they signed up for the study - was tracked up to March 2016 or until they had their first heart attack or stroke, whichever came first.
During a monitoring period spanning around seven years, 9,054 cases of cardiovascular disease were recorded, a third (34%) of which were in women. This included 5,782 cases of coronary artery disease (28% women) and 3,489 cases of stroke (43% women).
Analysis of the data showed that:
- Women who had started having periods before the age of 12 had a 10% increased risk of developing cardiovascular disease than those who had been 13 or older when they started.
- Women who went through the menopause early (before the age of 47) had a 33% increased risk of cardiovascular disease, rising to 42% for their risk of stroke.
- Previous miscarriages were associated with a higher risk of heart disease, with each miscarriage increasing the risk by 6%.
- Stillbirth was associated with a higher risk of cardiovascular disease in general (22%) and of stroke in particular (44%).
- Hysterectomy was linked to a heightened risk of cardiovascular disease (12%) and of heart disease (20%). And women who had had their ovaries removed before a hysterectomy were twice as likely to develop cardiovascular disease as those who hadn’t had these procedures.
- Young age at first parenthood seemed to be another risk factor, with each additional year of age lessening the risk of cardiovascular disease by around 3%. The link between the number of children and cardiovascular disease was similar for men and women, suggesting that social, psychological, and behavioural factors may be more important than biological ones.
The researchers noted that the study was observational, so no firm conclusions can be drawn about cause and effect. Nevertheless, the study was large, and the researchers were able to account for a range of potentially influential factors.
“More frequent cardiovascular screening would seem to be sensible among women who are early in their reproductive cycle, or who have a history of adverse reproductive events or a hysterectomy, as this might help to delay or prevent their onset of [cardiovascular disease]” they advised.
BHF’s Christopher Allen told HuffPost UK: “Further studies are needed to better understand if and how a women who starts her period before the age of 12 has a higher risk of heart disease in later life, along with the impact of other factors such as early menopause, pregnancy complications and hysterectomies.
“It’s important that women of all ages look after their hearts, and those over 40 take advantage of the free NHS health checks which cover your risk of cardiovascular disease.
“If you are worried about your reproductive history and heart disease then speak to your GP.”