Age at natural menopause and total mortality and mortality from ischemic heart disease: The Adventist health study

We studied the relationship between age at natural menopause and total mort ality as well as mortality from ischemic heart disease in a cohort of 6182 California Seventh Day Adventist women who reported a natural menopause. Du ring follow-up from 1976 through 1988, there were 1831 deaths. A total of 3 08 deaths due to ischemic heart disease occurred in women who denied ischem ic heart disease at start of follow-up. An early menopause was associated w ith increased total mortality (P value for linear trend <0.001) and ischemi c heart disease mortality (P value for linear trend = 0.03). This relations hip could not be explained by possible confounding variables. Our results s upport the hypothesis that an early natural menopause (35-40 years old) inc reases the risk of ischemic heart disease. There is, however, also some evi dence of increased risk of ischemic heart disease in women with a very late menopause (>55 years), particularly in women who never have used postmenop ausal estrogens. (C) 1999 Elsevier Science Inc.