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Associations of the ages at menarche and menopause with blood pressure and hypertension among middle-aged and older Chinese women: a cross-sectional analysis of the baseline data of the China Health and Retirement Longitudinal Study

Hypertension Researchvolume 42pages730738 (2019) | Download Citation

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Abstract

We evaluated the associations of the ages at menarche and menopause with blood pressure (BP) and hypertension using the baseline data of 7893 women from the China Health and Retirement Longitudinal Study, a nationally representative survey among Chinese adults aged ≥45 years. Multivariate linear and logistic regression analyses were performed to evaluate the associations of the ages at menarche and men`opause with BP and hypertension, respectively. Nonlinear associations were evaluated using spline analyses. After controlling for age, education, marital status, living areas, smoking, drinking, and medication use if necessary, an early onset of menarche by 1 year was associated with a 6% (95% confidence interval [CI]: 3–9%) higher odds of hypertension and 0.82 mm Hg (P < 0.001) and 0.41 mm Hg (P < 0.001) higher systolic and diastolic BP, respectively. When further controlling for the body mass index (BMI), blood glucose, and lipids, the associations were still significant. Spline analyses did not support U-shaped relationships between menarche age and hypertension risk (P = 0.35), systolic BP (P = 0.60), or diastolic BP (P = 0.70). When stratified by location of residence, menarche age was only associated with BP and hypertension among women living in rural areas. The age of menopause was positively associated with hypertension (odds ratio [OR] = 1.02 per year delay of menopause, 95% CI: 1.01–1.03). However, when further controlling for BMI, such an association no longer existed (OR = 1.01, P = 0.32). These findings indicated that the associations of menarche age with BP and hypertension may be modified by factors related to the area of residence in China, and the association between menopause age and hypertension was driven by BMI.

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Acknowledgements

We thank Mr. Kevin A. Spiegel for editing assistance.

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Author notes

  1. These authors contributed equally: L. Shen, L. Wang, Y. Hu

Affiliations

  1. Department of Epidemiology & Biostatistics, University of Georgia College of Public Health, Athens, GA, USA

    • Luqi Shen
    • , Ye Shen
    • , Ruiyuan Zhang
    • , Toni Miles
    •  & Changwei Li
  2. Department of Obstetrics and Gynaecology, Shanghai Baoshan Luo Dian Hospital, Shanghai, China

    • Li Wang
  3. Department of Obstetrics and Gynaecology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, Sichuan Province, China

    • Ying Hu
  4. School of Nursing, University of Arkansas College of Education and Health Professions, Fayetteville, AR, USA

    • Tingting Liu
  5. Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    • Jinzhen Guo

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Conflict of interest:

The authors declare that they have no conflict of interest.

Ethics approval:

The CHARLS study data are publicly available and are open to researchers all over the world. The current study is a secondary analysis of the deidentified CHARLS study data. The Institutional Review Boards at the University of Georgia granted the current study exemption from review.

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Correspondence to Changwei Li.

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https://doi.org/10.1038/s41440-019-0235-5