Premature Menopause May Independently Predict Pulmonary Hypertension Risk

Sarfaroj Khan 


March 15, 2021


  • Premature menopause (occurring before age 40 years) was independently associated with a 2-fold risk of pulmonary hypertension (PH).

  • Further increase in PH risk was seen with progressively earlier age at menopause.

Why this matters

  • Further investigation of the role of sex hormones in PH is required to elucidate pathobiology and identify novel therapeutic targets.

Study design

  • This cohort study included 136,715 postmenopausal women (age, 40-69 years; 5201 (3.8%) had premature menopause) from the UK Biobank who were followed up for a median of 11.1 years (interquartile range, 10.5-11.8).

  • Primary outcome: incident PH.

  • Funding: None.

Key results

  • A total of 447 women (overall cumulative incidence, 0.33%) were diagnosed with incident PH (38 [0.73%] women with premature menopause and 409 [0.31%] without).

  • After adjustments, premature menopause was independently associated with an increased risk of PH (adjusted HR [aHR], 2.13; 95% CI, 1.31-3.23; P<.001).

  • The risk of PH increased progressively with younger age at menopause (Ptrend<.001).

  • Compared with women who experienced menopause after age 50 years, the risk of PH was higher with menopause before age 30 years (HR, 4.82; 95% CI, 1.82-12.74; P=.002).

  • Ever use of menopausal hormonal therapy was not associated with incident PH (aHR, 0.90; 95% CI, 0.73-1.12; P=.36) and did not modify the association of premature menopause with PH (Pinteraction=.63).


  • Incident PH diagnoses were determined from International Classification of Disease codes rather than invasive haemodynamics.


Honigberg MC, Patel AP, Lahm T, Wood MJ, Ho JE, Kohli P, Natarajan P. Association of premature menopause with incident pulmonary hypertension: A cohort study. PLoS One. 2021;16(3):e0247398. doi: 10.1371/journal.pone.0247398. PMID: 33690615.  View full text 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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