Menopause age and hypercholesterolemia comorbidities: a region-wide retrospective cohort study in Andalusia, Spain (2016-2022)

Objectives To quantify sex- and age-related differences in hypercholesterolaemia diagnosis and associated comorbidities around the menopausal transition, using a population-based real-world dataset. Design Retrospective, multicentre, non-interventional observational cohort study.

Setting Region-wide public healthcare system data (primary and secondary care) from Andalusia (Spain), 2016 - 2022. Participants All adult patients meeting inclusion criteria with a recorded diagnosis of hypercholesterolaemia between 1 January 2016 and 31 December 2022 (n=557 034; 227 834 men and 329 200 women).

Interventions None. Primary and secondary outcome measures Primary outcomes were age- and sex-stratified patterns of hypercholesterolaemia diagnosis and comorbidity burden before and after age 50 years (proxy for post-menopausal age).

Secondary outcomes included comorbidity-specific comparisons between sexes across age strata and trajectory-based analyses (OR trajectories and incidence-ratio summaries). Results Women were diagnosed later than men (mean age 59.1 vs 56.0 years; mean difference 3.1 years, 95% CI 3.03 to 3.17).

Hypercholesterolaemia diagnoses in women rose sharply around ages 50 - 55 and remained higher than in men at older ages.