Women going through menopause before reaching 40 are more likely to experience heart problems, according to a new study.

Published in the European Heart Journal, a journal of the European Society of Cardiology (ESC), the new study found that the younger the age at menopause, the higher the risk for new-onset heart failure and atrial fibrillation.

The study was done on more than 1.4 million women aged 30 years and older who completed the Korean National Health Insurance System (NHIS) health check-up back in 2009.

“Women with premature menopause should be aware that they may be more likely to develop heart failure or atrial fibrillation than their peers. This may be good motivation to improve lifestyle habits known to be linked with heart disease, such as quitting smoking and exercising,” said study author Dr. Ga Eun Nam of Korea University College of Medicine, Seoul, Republic of Korea.

Usually, cardiovascular disease occurs up to 10 years later in women compared to men. Based on studies, premenopausal women are thought to benefit from the protective effect of estrogen on the cardiovascular system. However, the cessation of menses and subsequent decline of estrogen levels may make women more vulnerable to cardiovascular disease.

Premature menopause affects around 1% of women under 40. Previous studies found a link between premature (before age 40) and early (before age 45) menopause and cardiovascular disease. However, the evidence surrounding heart failure and atrial fibrillation were limited.

The new study examined the associations between premature menopause, age at menopause, and incident heart failure and atrial fibrillation. With data from the NHIS, the research team followed up with the participants until the end of 2018 for new-onset heart failure and atrial fibrillation.

After analyzing the associations between age at menopause and incidence of heart failure and atrial fibrillation and adjusting for the same factors, the team found that the risk for heart failure increased as the age of menopause decreased.

“Our study indicates that reproductive history should be routinely considered in addition to traditional risk factors such as smoking when evaluating the future likelihood of heart failure and atrial fibrillation,” concluded Dr. Nam.