News
Earlier menopause may harm heart-brain health connection, study suggests

Women who experience menopause earlier in life may face damage to the connection between heart function and brain health, new research suggests.
The study of more than 500 participants examined whether an earlier age at menopause affects the relationship between cardiac performance and cognitive function, as well as changes in brain structure.
Researchers from the University of Toronto and Sunnybrook Research Institute assessed how reduced heart function and early menopause together influence brain health in women, who are already at greater risk of both cardiovascular disease and Alzheimer’s disease.
Heart performance was measured using resting left ventricular ejection fraction — the proportion of blood pumped out with each heartbeat — captured through cardiac MRI scans.
Brain MRI scans assessed grey matter volume (the nerve-cell-rich tissue) and white matter hyperintensity burden, which indicates areas of damage linked to ageing and vascular disease.
Participants also completed standardised cognitive tests, with results adjusted for factors including age, ethnicity, education, hormone therapy use and whether menopause occurred naturally or through surgery.
The findings suggest that early menopause and reduced heart function may have a combined negative impact on the brain.
Weaker cardiac output can limit oxygen and nutrient flow to brain tissue, increasing the risk of damage and dementia over time.
Tallinn Splinter is lead author from the University of Toronto and Sunnybrook Research Institute.
The researcher said: “We still don’t fully understand how menopause, and particularly earlier menopause, affects brain ageing.
“By examining the link between heart and brain health, we wanted to shed light on this important but often overlooked area.”
Previous studies have shown that earlier menopause is linked with higher risks of cognitive decline and Alzheimer’s disease.
This research builds on that evidence by showing how menopause timing and heart health interact to influence brain outcomes.
Dr Stephanie Faubion, medical director for The Menopause Society, said: “These findings highlight the importance of including sex-specific factors, such as age at menopause, in dementia research and in developing prevention and intervention strategies.”
Wellness
Being female not a universal stroke risk factor for patients with AF, study finds

Female sex may not raise stroke risk across all atrial fibrillation (AF) patients, with higher risk mainly seen in women aged 75 and older, a study suggests.
Researchers said stroke prevention for women with the condition should be more personalised, especially for patients under 75.
Dr Amitabh C Pandey, director of cardiovascular translational research at Tulane University School of Medicine, said: “For years, female sex has been included as a risk factor along with other factors such as high blood pressure and diabetes, meaning women were more likely to be prescribed anticoagulants.
“Our study shows younger women may not have as much added stroke risk as previously thought, while older women, particularly those over 75, appear to have a higher risk that deserves close attention.”
The new Tulane University study challenges a long-standing assumption in heart care that being female automatically increases stroke risk for patients with atrial fibrillation.
Atrial fibrillation, often called AF, is a common heart rhythm disorder that causes the heart to beat irregularly.
It is associated with a higher risk of stroke and is often treated with anticoagulants, also known as blood thinners.
The study found that stroke risk did not increase equally across all female patients with AF.
Instead, researchers said being female may act more as a risk modifier, with increased stroke risk seen primarily among women aged 75 and older or those with a greater burden of other health conditions.
Clinicians often use a scoring system to decide whether people with AF should be prescribed blood thinners.
The system gives points for factors including age, heart failure, diabetes, previous stroke, vascular disease and high blood pressure.
Women also receive one point for sex alone.
Researchers said this can mean women with AF become eligible for blood thinners earlier or more often than men with otherwise similar risk profiles.
While blood thinners can help prevent clot-related strokes, they can also increase the risk of bruising, prolonged bleeding, gastrointestinal bleeding and other serious complications.
The researchers analysed approximately 950,000 patients with AF using TriNetX, a large anonymised electronic health record database.
They compared stroke outcomes between male and female patients across three age groups: younger than 65, 65 to 74, and 75 and older.
Male and female patients were matched based on age, other health problems and whether they had been prescribed anticoagulation medicine.
Among patients younger than 75, the study found no significant difference in one-year stroke risk between men and women.
However, among patients aged 75 and older, women had a modest but statistically significant increase in stroke risk compared with men.
In patients aged 75 and older with no additional risk factors beyond age, women had about one additional stroke per 629 patients compared with their male counterparts.
The findings support growing interest in a newer AF risk score, known as CHA2DS2-VA, which removes sex as a standalone risk factor.
However, researchers said more studies are needed and medical guidance remains inconsistent.
Han Feng, assistant professor at Tulane University School of Medicine, said: “This general approach came from women being underrepresented in AFib trials and studies comprising only about one-third of study populations.
“Our study shows not all women with AFib have the same risk profile, and these decisions should be individualised.
Pandey said: “These findings highlight the need for modern tools and approaches that can personalise risk profiles to individuals.
“The goal is not to undertreat patients who need stroke prevention, but to better identify who is most likely to benefit from anticoagulation and who may be exposed to unnecessary risk.”
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