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International Journal of Epidemiology 2009 38(1):245-252; doi:10.1093/ije/dyn251
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Age at menarche, total mortality and mortality from ischaemic heart disease and stroke: the Adventist Health Study, 1976–88

B K Jacobsen1,*, K Oda2, S F Knutsen2 and G E Fraser2,3

1Institute of Community Medicine, University of Tromsø, Tromsø, N-9037 Tromsø, Norway.
2Department of Epidemiology and Biostatistics, School of Public Health, Loma Linda University, Loma Linda CA 92350, USA.
3Center for Health Research, School of Public Health, Loma Linda University, Loma Linda CA 92350, USA.

* Corresponding author. Institute of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway. E-mail: bjarne.jacobsen{at}ism.uit.no


  Abstract

Background Little is known about the relationship between age at menarche and total mortality and mortality from ischaemic heart disease and stroke.

Methods A cohort study of 19 462 Californian Seventh-Day Adventist women followed-up from 1976 to 1988. A total of 3313 deaths occurred during follow-up, of which 809 were due to ischaemic heart disease and 378 due to stroke.

Results An early menarche was associated with increased total mortality (P-value for linear trend <0.001), ischaemic heart disease (P-value for linear trend = 0.01) and stroke (P-value for linear trend = 0.02) mortality. There were, however, also some indications of an increased ischaemic heart disease mortality in women aged 16–18 at menarche (5% of the women). When assessed as a linear relationship, a 1-year delay in menarche was associated with 4.5% (95% CI 2.3–6.7) lower total mortality. The association was stronger for ischaemic heart disease [6.0% (95% CI 1.2–10.6)] and stroke [8.6% (95% CI 1.6–15.1)] mortality.

Conclusions The results suggest that there is a linear, inverse relationship between age at menarche and total mortality as well as with ischaemic heart disease and stroke mortality.

Keywords Myocardial infarction, menarche, mortality, stroke

Accepted 28 October 2008


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