Women’s reproductive health linked to risk of heart disease and stroke

Girls who start their periods before they turn 12 are at greater risk of developing heart disease and stroke in later life, according to a new study of nearly 300,000 women in the UK by The George Institute for Global Health at the University of Oxford. 

Women who give birth at a young age, experience miscarriage or stillbirth, or who go through the menopause early, are also more likely to develop cardiovascular disease when they get older, the study found.

‘This study clarifies the mixed findings of previous research, and underlines the life-long impact of women’s reproductive health,’ said lead author Dr Sanne Peters, Research Fellow in Epidemiology at The George Institute, Oxford.

‘Our research suggests policymakers should consider implementing more frequent screening for cardiovascular disease among women with one or more of the risk factors highlighted here, in order to put in place measures that can help delay or prevent the development of heart disease and stroke.’

The early onset of periods in girls has been linked to childhood obesity, and several studies – including a prior study among these women – show that early menarche is also associated with obesity in adulthood, a known risk factor for cardiovascular disease. However, there is no straightforward link.

‘Our findings show that the risk of developing cardiovascular disease increases for both women of healthy weight and women who are overweight or obese, which suggests we need more research to understand the association between an early first menstrual cycle and a greater risk of heart disease and stroke in later life,’ said Peters.

Interestingly, the study found that the risk of developing cardiovascular disease increases by 3% for both women and men with each child parented. Women with children have a 21% higher risk of heart disease than those who don’t have children, while men with children have a 13% higher risk of heart disease than those without. However, neither men nor women with children are at greater risk of having a stroke.

The similarity between women and men in the risk of heart disease and stroke associated with having children suggests this link may be explained by the social, psychological and behavioural aspects of parenthood, rather than biological factors related to pregnancy.

Researchers at The George Institute, Oxford, drew on data from the UK Biobank, a large, population-based study of more than half a million men and women. They found that women who had started their periods before the age of 12 had a 10% greater risk of developing cardiovascular disease than those who had been 13 or older, while those who went through the menopause before the age of 47 had a 33% higher risk of developing heart disease and 42% greater risk of stroke.

Each miscarriage was found to increase a woman’s risk of heart disease by 6%, while giving birth to a stillborn child was associated with a 22% higher risk of cardiovascular disease and a 44% higher risk of stroke. Women who had undergone hysterectomies or had their ovaries removed were also found to be at a higher risk of heart disease and stroke.

Read the full study paper in Heart BMJ.