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Cardiovascular disease risk in women with premature ovarian insufficiency: A systematic review and meta-analysis
Abstract
AIMS: The purpose of this review was to assess the relationship between premature ovarian insufficiency (POI), defined as natural menopause <40 years, and risk of ischaemic heart disease (IHD), stroke and overall cardiovascular disease (CVD). METHODS AND RESULTS: We performed a systematic search in PubMed (1966-2012), EMBASE (1980-2012). Studies were included if they were prospective, follow-up>3 years, assessment of age menopause <40 years, and incident cases of fatal or nonfatal IHD, stroke, or overall CVD. Relative risks (RRs) and 95% confidence interval (CI) were pooled using a random-effect model. Overall, 10 observational studies were identified, comprising 190,588 women (follow-up 4-37 years) with 9440 events (2026 events for IHD (seven studies) and 6438 events for stroke (seven studies) and 976 for total CVD (two studies). POI was assessed by questionnaire and incident cases through certification and event registers. POI was related to an increased risk of developing or dying from IHD (hazard ratio (HR) 1.69, 95% CI 1.29-2.21, p = 0.0001) and total CVD (HR 1.61, 95% CI 1.22-2.12, p = 0.0007). No relation was found for stroke (HR 1.03, 0.88-1.19, p = 0.74). We found no evidence for heterogeneity. CONCLUSION: POI is an independent though modest risk factor of IHD and overall CVD but not of stroke. Because of the limited impact of POI on CVD risk compared to classical cardiovascular risk factors, it is unlikely that POI will be implemented as modifier of cardiovascular risk classification.
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“Overall, women who experienced menopause earlier than age 40 (premature ovarian insufficiency) had a 1.6-fold risk of developing composite cardiovascular disease compared with women without premature ovarian insufficiency.96”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [96]
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“This association was related to the development of ischaemic heart disease96; no association was found with stroke.”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [96]
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“This association was related to the development of ischaemic heart disease96; no association was found with stroke.”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [96]
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Metadata
- Authors
- Roeters van Lennep, J. E., Heida, K. Y., Bots, M. L., Hoek, A., & on behalf of the collaborators of the Dutch Multidisciplinary Guideline Development Group on Cardiovascular Risk Management after Reproductive Disorders
- Affiliations
- Department of Internal Medicine, Erasmus MC, the Netherlands
- University Medical Center Utrecht (NL)
- University of Groningen (NL)
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-10-20
- Volume
- 23
- Issue
- 2
- Pages
- 178-186
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W2120592625
- Cited by
- 273
- References
- 31
- Citations by year
- 2026: 24 · 2025: 29 · 2024: 23 · 2023: 29 · 2022: 34 · 2021: 25 · 2020: 24 · 2019: 29 · 2018: 21 · 2017: 16 · 2016: 7 · 2015: 11 · 2014: 1
- FWCI
- 1.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- premature ovarian insufficiency, cardiovascular risk, ischemic heart disease, stroke, women, natural menopause, cardiovascular risk factors, cardiovascular risk classification
- MeSH terms
- Cardiovascular Diseases, Female, Humans, Risk Factors, Primary Ovarian Insufficiency, Stroke
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