TOPLINE:

The menopausal transition was associated with a significant increase in hypercholesterolaemia diagnoses and a substantially greater burden of multimorbidity in women than in men, particularly across cardiovascular, metabolic, endocrine, neurologic, and mental conditions.

METHODOLOGY:

• Researchers conducted a multicentre observational cohort study using population-based real-world data to assess age- and sex-specific patterns of hypercholesterolaemia diagnoses and associated comorbidity burdens around the menopausal transition.
• They included 557,034 patients aged 18 years or older with hypercholesterolaemia between 2016 and 2022, of whom 227,834 were men and 329,200 were women.
• Differences in age at the hypercholesterolaemia diagnosis pattern and comorbidity burden were compared between women and men before and after the age of 50 years (used as a proxy for postmenopausal age).
• Age-varying differences in comorbidity patterns between men and women were also evaluated.

TAKEAWAY:

• Women were diagnosed with hypercholesterolaemia at a later age than men (mean age, 59.1 vs 56.0 years). The incidence of hypercholesterolaemia diagnoses increased more rapidly in women around ages of 50-55 years than in men and remained higher in older age groups.
• Women aged 50 years or older had a significantly higher burden of comorbidities including mental, cardiovascular, endocrine, metabolic, bone and joint, neurologic, and liver disorders and cancers than men (P < .001 for all).
• Osteoarthritis and spondylosis (woman-to-man incidence ratio [WMIR], 1.19), hypertension (WMIR, 1.63), and anxiety disorder (WMIR, 1.38) were more frequently reported in women aged 50 years or older than in men (P < .001 for all).
• Women showed a more pronounced increase in comorbidities including gout and other crystal-induced arthropathies (WMIR, 4.65), other organic mental disorders (WMIR, 4.02), and autism spectrum disorder (WMIR, 3.44) than men (P < .001 for all).

IN PRACTICE:

"At the policy level, our findings support the value of sex- and age-stratified quality indicators for dyslipidaemia management in routine care, including timely identification of hypercholesterolaemia and systematic reassessment of risk at midlife," the authors wrote.

SOURCE:

This study was led by Alberto Esteban-Medina, Andalusian Platform for Computational Medicine, Fundación Pública Andaluza Progreso y Salud MP, Seville, Spain. It was published online on June 09, 2026, in BMJ Open.

LIMITATIONS:

Menopause age was used as a proxy, which may have introduced the misclassification of menopausal status. The observational design using routinely collected healthcare data restricted causal inference. Residual confounding cannot be ruled out because data on key variables were not available or incomplete.

DISCLOSURES:

The infrastructure supporting this work received funding from the Consejería de Salud y Consumo de la Junta de Andalucía and the Spanish Ministry of Science and Innovation. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.