Systolic blood pressure as the mediator of the effect of early menarche on the risk of coronary artery disease: A Mendelian randomization study

Hsien Yu Fan, Yen Tsung Huang, Yun Yu Chen, Justin Bo Kai Hsu, Hung Yuan Li, Ta Chen Su, Hung Ju Lin, Kuo Liong Chien, Yang Ching Chen

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: Menarche timing may not be directly associated with the risk of coronary artery disease (CAD). Therefore, we investigated the roles of metabolic factors in explaining the effect of age at menarche on CAD risk. Methods: We identified women with age at menarche and CAD by using three analytical methods: Mendelian randomization (MR), logistic regression analysis, and Cox proportional hazard regression. The first two analyses were performed in the Taiwan Biobank (N = 71,923) study, and the last analysis was performed in the Chin-Shan Community Cardiovascular Cohort study (N = 1,598). We further investigated the role of metabolic factors in mediating the effect of age at menarche on CAD risk by using three complementary methods with mediation analyses. Results: One standard deviation of earlier age at menarche was associated with a 2% higher CAD risk [odds ratio = 1.02, 95% confidence interval (CI) = 1.001–1.03] in the MR analysis, an 11% higher risk (odds ratio = 1.11, 95% CI = 1.02–1.21) in the logistic regression analysis, and a 57% higher risk (hazard ratio = 1.57, 95% CI = 1.12–2.19) in the Cox proportional hazard regression. All the analyses consistently supported the role of systolic blood pressure in mediating this effect. The MR results indicated that 29% (95% CI = 26%–32%) of the effect of genetically predicted earlier age at menarche on CAD risk was mediated by genetically predicted systolic blood pressure. Conclusion: The results obtained using different analytical methods suggest that interventions aimed at lowering systolic blood pressure can reduce the cases of CAD attributable to earlier age at menarche.

Original languageEnglish
Article number1023355
JournalFrontiers in Cardiovascular Medicine
Volume9
DOIs
Publication statusPublished - Jan 9 2023

Keywords

  • cardiovascular disease
  • mediator
  • menarche age
  • Mendelian randomization
  • metabolic factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Systolic blood pressure as the mediator of the effect of early menarche on the risk of coronary artery disease: A Mendelian randomization study'. Together they form a unique fingerprint.

Cite this