{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:30:13Z","timestamp":1784248213350,"version":"3.55.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,4,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The mechanisms linking menopausal age and heart failure (HF) incidence are controversial. We investigated for heterogeneity by obesity on the relationship between menopausal age and HF incidence.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Using postmenopausal women who attended the Atherosclerosis Risk in Communities Study Visit 4, we estimated hazard ratios of incident HF associated with menopausal age using Cox proportional hazards models, testing for effect modification by obesity and adjusting for HF risk factors. Women were categorized by menopausal age: &lt;45\u00a0years, 45 to 49\u00a0years, 50 to 54\u00a0years, and \u226555\u00a0years. Among 4441 postmenopausal women, aged 63.5\u00b15.5\u00a0years, there were 903 incident HF events over a mean follow\u2010up of 16.5\u00a0years. The attributable risk of generalized and central obesity for HF incidence was greatest among women who experienced menopause at age \u226555\u00a0years: 11.09\/1000 person\u2010years and 7.38\/1000 person\u2010years, respectively. There were significant interactions of menopausal age with body mass index and waist circumference for HF incidence,\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              0.02 and 0.001, respectively. The hazard ratios of incident HF for a SD increase in body mass index was elevated in women with menopausal age &lt;45\u00a0years [1.39 (1.05\u20131.84)]; 45\u201349\u00a0years [1.33, (1.06\u20131.67)]; and \u226555\u00a0years [2.02, (1.41\u20132.89)]. The hazard ratio of incident HF for a SD increase in waist circumference was elevated only in women with menopausal age \u226555\u00a0years [2.93, (1.85\u20134.65)].\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">As obesity worsened, the risk of developing HF became significantly greater when compared with women with lower body mass index and waist circumference, particularly among those who had experienced menopause at age \u226555\u00a0years.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.024461","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T09:41:27Z","timestamp":1649842887000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Relationship Between Age at Menopause, Obesity, and Incident Heart Failure: The Atherosclerosis Risk in Communities Study"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9687-7541","authenticated-orcid":false,"given":"Imo A.","family":"Ebong","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Division of Cardiovascular Medicine University of California Davis Sacramento CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1734-2755","authenticated-orcid":false,"given":"Machelle D.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Division of Biostatistics University of California Davis Sacramento CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duke","family":"Appiah","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences Department of Public Health Texas Tech University Health Sciences Center Lubbock 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