Age at menopause and risk of ischemic stroke: a systematic review and meta-analysis

Abstract

AbstractBackgroundDespite its importance in being among the top 10 causes of old women death, there is limited data on age at menopause and ischemic stroke.AimsWe performed a systematic review and meta-analysis to estimate the effect of age at onset of menopause on ischemic stroke.MethodsWe screened four databases (PubMed, Cochrane, Web of Science, and EMBASE databases) up to July 17, 2023. This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and was registered with PROSPERO (CRD42023444245). Data extraction and quality assessment were independently undertaken by two reviewers. A random-effects model was used for meta-analysis using Revman5.4 to calculate the risk ratio of the incidence of ischemic stroke. Heterogeneity was assessed using I2. Meta-regression and assessment for bias were performed.ResultsOut of 725 records identified, 10 studies were included in the qualitative synthesis and the quantitative meta-analysis. The pooled incidence rate for ischemic strokes which age at onset of menopause before 43 years old was 1.22 (95% confidence interval (CI): 1.02-1.46). The pooled incidence rate of early menopause was 1.26 (95% CI: 1.07-1.48) for ischemic stroke. The incidence rate of ischemic stroke for women with early menopause may be in an environment with a high incidence for a long time.ConclusionEvidence from this meta-analysis suggests that early menopause is associated with an increased risk of ischemic stroke. Age at onset of menopause before 43 years old may be the cut-off value of increased risk of ischemic stroke.