Association of premature menopause with incident pulmonary hypertension: A cohort study

Several forms of pulmonary hypertension (PH) disproportionately affect women. Animal and human studies suggest that estradiol exerts mixed effects on the pulmonary vasculature. Whether premature menopause represents a risk factor for PH is unknown. In this cohort study, women in the UK Biobank aged...

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Bibliographic Details
Published in:PloS one 2021-03, Vol.16 (3), p.e0247398-e0247398
Main Authors: Honigberg, Michael C, Patel, Aniruddh P, Lahm, Tim, Wood, Malissa J, Ho, Jennifer E, Kohli, Puja, Natarajan, Pradeep
Format: Article
Language:English
Subjects:
Age
Antihypertensives
Aorta
Aortic stenosis
Apnea
Arteriosclerosis
Atherosclerosis
Biobanks
Biology and Life Sciences
Blood pressure
C-reactive protein
Cancer
Cardiology
Cardiovascular disease
Cholesterol
Chronic obstructive pulmonary disease
Cohort analysis
Complications and side effects
Congestive heart failure
Coronary artery
Coronary artery disease
Critical care
Data analysis
Demographic aspects
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Editing
Estrogens
Ethnicity
Genetics
Health care facilities
Heart failure
Hormones
Hospitals
Hypersensitivity
Hypertension
Hysterectomy
Infectious diseases
Lung diseases
Medical research
Medical schools
Medicine
Medicine and Health Sciences
Menopause
Methodology
Minority & ethnic groups
Obstructive lung disease
Physiological aspects
Population genetics
Proteins
Pulmonary hypertension
Race
Regurgitation
Research facilities
Reviews
Risk analysis
Risk factors
Sleep
Sleep apnea
Sleep disorders
Smoking
Statistical models
Stenosis
Supervision
Thromboembolism
Womens health
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Summary:Several forms of pulmonary hypertension (PH) disproportionately affect women. Animal and human studies suggest that estradiol exerts mixed effects on the pulmonary vasculature. Whether premature menopause represents a risk factor for PH is unknown. In this cohort study, women in the UK Biobank aged 40-69 years who were postmenopausal and had complete data available on reproductive history were included. Premature menopause, defined as menopause occurring before age 40 years. Postmenopausal women without premature menopause served as the reference group. The primary outcome was incident PH, ascertained by appearance of a qualifying ICD code in the participant's UK Biobank study record. Of 136,715 postmenopausal women included, 5,201 (3.8%) had premature menopause. Participants were followed up for a median of 11.1 (interquartile range 10.5-11.8) years. The primary outcome occurred in 38 women (0.73%) with premature menopause and 409 (0.31%) without. After adjustment for age, race, ever-smoking, body-mass index, systolic blood pressure, antihypertensive medication use, non-high-density lipoprotein cholesterol, cholesterol-lowering medication use, C-reactive protein, prevalent type 2 diabetes, obstructive sleep apnea, heart failure, mitral regurgitation, aortic stenosis, venous thromboembolism, forced vital capacity (FVC), the forced expiratory volume in 1 second-to-FVC ratio, use of menopausal hormone therapy, and hysterectomy status, premature menopause was independently associated with PH (hazard ratio 2.13, 95% CI 1.31-3.23, P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0247398