March 2026

CARDIOVASCULAR

PREMATURE MENOPAUSE LINKED WITH 40% INCREASE IN LONG-TERM HEART DISEASE RISK

Featuring: Priya Freaney, MD
Women who enter natural menopause before age 40 face about a 40% higher lifetime risk of developing coronary heart disease than women who experience menopause later, according to a large Northwestern Medicine study. The study, published in JAMA Cardiology, is the first to calculate lifetime heart risk associated with premature menopause.

Study Details
The study analyzed data from 10,036 postmenopausal Black and white women who participated in six long-running U.S. studies between 1964 and 2018.

​Even after accounting for cardiovascular risk factors such as smoking, obesity, hypertension and diabetes, premature menopause was associated with 41% higher risk of coronary heart disease for Black women and 39% increased risk for white women.

Study Context
Investigators typically define premature menopause as menopause before age 40. The causes are not fully understood and are likely multifactorial.
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It is unclear whether the menopausal transition itself creates a vascular environment that promotes disease, or whether women who experience premature menopause already have an underlying risk profile that predisposes them to both premature menopause and cardiovascular disease.

​Practice Implications
Cardiovascular clinicians should routinely ask about menopause history when assessing long-term cardiovascular risk.

“When menopause happens before age 40, women still have more than half of their life expectancy ahead of them,” says study lead author Priya Freaney, MD. “Understanding their cumulative lifetime risk of blockage-related heart disease is critical.”
Priya Freaney, MD, Director of the Northwestern Medicine Women’s Heart Care Program at Bluhm Cardiovascular Institute,  Assistant Professor of Cardiology at Northwestern Medicine 

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