The relationship between menopausal age and heart failure (HF) risk remains a subject of ongoing debate. While menopause is a natural transition, it is often accompanied by metabolic changes, including increased adiposity, which may contribute to cardiovascular disease. Adipose tissue functions as an endocrine organ, secreting adipokines that regulate inflammation, metabolism, and cardiovascular health. However, the precise role of adipokines in the development of HF after menopause remains unclear. Women who experience early menopause may face a higher risk of HF due to prolonged exposure to adverse metabolic changes.
A study by Ebong et al., published in the journal “Menopause”, investigated the association between menopausal age, serum adipokine levels, and HF risk in postmenopausal women. The study included 746 postmenopausal women (mean age 65.1 years) from the Multi-Ethnic Study of Atherosclerosis (MESA) trial. Over a median follow-up of 17.8 years, 45 HF events were recorded. Early menopause was significantly associated with an increased HF risk (HR: 4.50–5.16) after adjusting for cardiovascular risk factors. Among the adipokines, only adiponectin independently predicted HF (HR: 2.20, 95% CI: 1.35-3.57). The findings suggest that early menopause is a significant risk factor for heart failure, with adiponectin emerging as the only adipokine independently associated with HF in postmenopausal women (See Graphic).
(Source: Ebong IA, Wilson M, Michos ED, Appiah D, Schreiner PJ, Racette SB, Allison M, Watson K, Bertoni A. Menopausal age, adipokines, and heart failure incidence in postmenopausal women of Multi-Ethnic Study of Atherosclerosis. Menopause. 2025; 32(1):10-97.)