Menopause before 40 tied to higher stroke risk

过早绝经可能意味着血管阻塞导致中风的风险增加, according to a new study. Yet for each year of menopause delay, stroke risk fell by 2%.

Stroke is the second-leading cause of death worldwide, and women have a 4% higher lifetime stroke risk than men. 一些研究表明，绝经年龄较早的女性患心脏病的风险更高. 但是关于中风和更年期开始的年龄之间的关系，研究得出了不同的结果.

这项研究于周四发表在美国心脏协会杂志上 Stroke, 研究了16244名年龄在26-70岁之间的荷兰绝经后妇女的数据.

在对这些女性进行了大约15年的跟踪调查并对各种因素进行了调整之后, 研究人员发现，在40岁之前绝经的女性有1.缺血性中风的风险是50-54岁女性的5倍. 研究人员还发现，绝经期每推迟一年，中风风险就会降低2%.

早期绝经和中风之间的风险仅限于缺血性中风, which is caused by a vessel blockage, and not hemorrhagic stroke, which occurs when a weakened vessel ruptures. 研究还发现，对于自然绝经的女性来说，绝经年龄与中风之间的联系比那些在卵巢切除手术后经历更年期的女性更强.

“对于所有女性来说，在绝经前后努力实现最佳心血管健康是至关重要的, but it is even more important for women with early menopause," said Dr. Yvonne van der Schouw, 该研究的合著者，荷兰乌得勒支大学慢性病流行病学教授.

研究结果表明，需要对提前绝经和中风风险之间的关系进行新的研究, van der Schouw said, adding that further studies "may eventually lead to new, still unknown pathways and new clues for preventive measures."

科学家们已经在研究更年期早期的激素替代疗法如何改善心血管健康. According to an AHA scientific statement published last year in its journal Circulation, certain hormone replacement therapies have cardiovascular benefits, decrease the risk of Type 2 diabetes and protect against bone loss.

A growing body of research also is looking at how estrogen impacts a woman's brain health.

A 2019 study in the journal Menopause 研究发现，尽早给女性服用雌激素——在绝经的前五年——可能会防止认知能力下降. 研究还表明，由于生育周期较长，女性接触天然雌激素的线上电子游戏飞禽走兽越长，她们在以后的生活中认知功能越好.

Dr. Samar El Khoudary, who was not involved in the new research, 说这项研究的局限性在于使用的数据依赖于参与者的问卷调查来报告更年期的细节.

Still, she said, “这项研究以及其他类似的研究帮助我们更好地意识到与更年期相关的心血管健康风险."

她呼吁进行更多的研究，以检验激素替代疗法如何影响绝经年龄和中风. “这是房间里的大象，因为中年妇女使用激素治疗更年期相关症状," said El Khoudary, 匹兹堡大学临床与转化科学研究所的流行病学副教授.

But whether or not they use hormone replacement therapy, 经历更年期的女性需要教育自己中风的风险以及如何预防, El Khoudary said.

"During midlife when women transition through menopause, women need to maintain physical activity, have a healthy diet and a healthy weight, stop smoking, and get enough sleep," she said. "At this stage, reducing their risk becomes very important."

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