Abstract P129: Age at Menarche Associated With Cardiovascular Disease Risk Factors and History Among African American Women: The Jackson Heart Study

Abstract

Menarche is the onset of menstruation and is a definitive indication of female puberty. The average age at menarche has steadily declined worldwide over the past century. While many cardiovascular conditions have their start during youth, age at menarche may also play a role in predicting the risk for cardiovascular disease (CVD). Of particular importance is the disproportionately high number of CVDs that affect African Americans, which contributes greatly to the disparities in life expectancy between African Americans and Whites. This study aims to address a gap in knowledge about African American women’s health by examining the association between age at menarche and CVD. We assessed the hypothesis that an earlier age at menarche is associated with increased odds of CVD risk factors and history for women in the Jackson Heart Study. This study was a secondary analysis of baseline data from 2,458 females in the Jackson Heart Study, a longitudinal cohort study of African Americans in the Jackson, MS metropolitan area. Early menarche was defined as menarche occurring at less than 12 years of age. Cardiovascular disease risk factors included hypertension, diabetes, obesity, and abdominal obesity (waist circumference >88cm). Cardiovascular disease history included coronary heart disease, heart attack, and stroke. The association between early menarche and CVD risk factors and history was examined using multivariable logistic regression models, controlling for physical activity, nutrition, smoking, alcohol use, education, income, and oral contraceptive use. The prevalence of CVD risk factors and CVD history was higher for women with an early age at menarche (<12 years) than for other women. After adjusting for covariates, early age at menarche was associated with greater odds of hypertension (OR, 1.47 [95% CI, 1.17-1.84]), obesity (OR, 1.77 [95% CI, 1.43, 2.19]), abdominal obesity (OR, 1.87 [95% CI, 1.44, 2.41)], history of coronary heart disease (OR, 1.98 [95% CI, 1.33, 2.94]), and history of heart attack (OR, 1.76 [95% CI, 1.09, 2.84]). Early age at menarche was not significantly associated with diabetes or stroke history. In conclusion, in this large sample of African American women in the Jackson Heart Study, we observed that menarche before 12 years of age was associated with increased odds of CVD risk factors and CVD history compared to those with menarche after 12 years of age. These findings highlight the importance of exposures during youth and childhood which may contribute to poor health outcomes in later life.