Abstract P219: Association Of Age At Menopause And Reproductive Years With Arterial Stiffness And Its 5-year Change: The Atherosclerosis Risk In Communities - Neurocognitive Study (ARIC-NCS)

Introduction: Early age at menopause is posited to increase cardiovascular disease (CVD) risk. However, studies examining the association with arterial stiffness, a predictor of CVD, are inconsistent and cross-sectional. Hypothesis: Earlier age at menopause and shorter reproductive years in women are associated with higher arterial stiffness and greater 5-year change at later life. Methods: We included 1,084 women in ARIC-NCS (mean 74 years at visit 5) with measures of arterial stiffness (carotid-femoral pulse wave velocity (cfPWV)) at visit 5 (2011-13) and visit 6 or 7 (2016-19). At visits 1-4, women self-reported age at first menses, age at menopause, and hysterectomy with and without bilateral oophorectomy. We defined menopause type as natural, surgical, and unknown, which included women with a hysterectomy, but unknown ovarian status. Multivariable linear regression was used to evaluate associations of age at menopause, early age at menopause (<45 years vs. ≥45 years), and reproductive years (age at menopause - age at first menses) with visit 5 cfPWV and cfPWV change between visit 5 and 6 or 7, adjusting for demographics and cardiometabolic risk factors. Results: The average age at menopause was 46.2 years, and 319 (29.4%) women had early age at menopause. No statistically significant associations were observed for age at menopause and reproductive years with either visit 5 cfPWV or cfPWV change. However, the associations with cfPWV change differed by menopause type (Table). Age at menopause and reproductive years were inversely associated with cfPWV change in women with natural menopause but were positively associated with cfPWV change in women with surgical menopause. Conclusion: At later life, age at menopause and reproductive years are not strongly associated with arterial stiffness, although the change in arterial stiffness differs by menopause type. Longitudinal arterial stiffness measures among women at mid-life is needed to understand the effect of natural versus surgical menopause on arterial stiffness.