Menopause and CAD - Chicken and Egg Situation

The online April 20th, JACC (Journal of the American College of Cardiology), published an epidermiological analysis of a thought provoking article, by Dr Helen Kok of the Utrecht University, Netherlands. Dr Kok analysed the data from the Framingham Study cohort of 695 subjects who were premenopausal at entry and followed till post menopause. She analysed the cardiovascular factors premenopausal and found that the onset of menopause was statistically related to the time of onset of menopause. She concluded that CVS disease risk may determine the age of women at menopause, and yet we all know that the onset of menopause heralds an increase in the risk of CAD.

The theory is that the increased CVS risk factors in these women may suggest ischemia of the blood supply to the ovaries or act direct on the endocrine system, to bring about the onset of menopause. Thought provoking, no?. It is important to note, that Lancet and New England Journal of Medicine refuse to publish this article. The Nature Medicine journal refused to even read the manuscript. That must give you an impression of what they think of this theory. Certainly more work is required in this area. Menopause may not be so simple after all.