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Cardiovascular diseases are the leading cause of mortality worldwide and are strongly influenced by obesity and hypertension. Age at menarche has been proposed as an early marker of cardiometabolic risk, but evidence in postmenopausal women is inconsistent, particularly in Mexico. We aimed to evaluate the association between early menarche and obesity and hypertension in postmenopausal women, and to examine whether obesity mediates this relationship. We conducted a cross-sectional study based on a retrospective review of 462 medical records of postmenopausal women who attended a tertiary hospital in Mexico City between January 2023 and August 2024. Early menarche was defined as <12 years. Obesity and hypertension were identified from records. Associations were estimated using Poisson regression with robust variance to obtain prevalence ratios (PRs) and 95% confidence intervals (CIs). We assessed effect modification by age at menopause and conducted a mediation analysis under the counterfactual framework to estimate the proportion of the menarche-hypertension association explained by obesity. Early menarche was associated with a higher prevalence of obesity (PR = 1.36, 95% CI = 1.08-1.70) and hypertension (PR = 1.34, 95% CI = 1.06-1.71). Associations were stronger among women with menopause at ≤45 years. Mediation analysis indicated that obesity explained 61.6% of this relationship, with a significant indirect effect (PR = 1.18, 95% CI = 1.05-1.33). Early menarche was independently associated with obesity and hypertension in postmenopausal women, with obesity acting as a potential intermediary factor. Given the cross-sectional design, causality cannot be established, but the associations observed are biologically and temporally coherent.

Background/Objectives: Hypertensive disorders of pregnancy (HDP) remain a major contributor to maternal morbidity and mortality worldwide, yet early-life reproductive factors such as age at menarche have been insufficiently explored in relation to HDP. Therefore, we aimed to evaluate the association between age at menarche and the risk of HDP in a cohort of Mexican pregnant women. Methods: We conducted a retrospective cohort study among 1344 women with singleton pregnancies receiving care at a tertiary hospital in Mexico City in 2024. Age at menarche was categorized as <12, 12–14, and >14 years. HDP diagnoses were extracted from clinical records. Poisson regression with robust variance was used to estimate adjusted risk ratios (RRs). Sensitivity analyses included alternative menarche categorizations and restricted cubic spline models. Counterfactual mediation analyses assessed indirect effects through reconstructed prepregnancy BMI and gestational diabetes. Results: Both early (<12 years) and late (>14 years) menarche were associated with higher HDP risk than the 12–14-year reference (adjusted RR = 1.81; 95% CI 1.42–2.30, and 1.74; 95% CI 1.27–2.38, respectively). Spline models confirmed a U-shaped association. Mediation analyses indicated that prepregnancy BMI did not meaningfully mediate the association for either early or late menarche (<5% mediated). Gestational diabetes explained a modest proportion of the association for early menarche (≈14%), but not for late menarche. Conclusions: Age at menarche showed a robust U-shaped association with HDP, mostly independent of adiposity and gestational diabetes, within the limits of the available measurements. Incorporating pubertal timing into routine reproductive history taking may enhance contextual risk assessment for HDP.

: Eating behavior disorders (EBDs) are a public health concern among undergraduate students. Evidence suggests that certain health-related academic environments may be associated with heightened psychological vulnerability. Hence, we aimed to evaluate the association between nursing education and the risk of EBDs and to assess whether self-esteem and anxiety mediate this relationship. : A cross-sectional analytical study was conducted between July and August 2023 among 433 undergraduate students from two public universities in Hidalgo, Mexico. The sample included 209 nursing students and 224 peers from non-health-related programs. Self-esteem, anxiety, and EBD risk were assessed using the Rosenberg Self-Esteem Scale, Hamilton Anxiety Rating Scale, and Eating Attitudes Test-26, respectively. Logistic regression and counterfactual mediation analyses were performed, adjusting for age, sex, family income, and year of study. : Nursing students showed higher odds of low self-esteem (aOR = 1.64; 95% CI: 1.06-2.53), anxiety (aOR = 2.06; 95% CI: 1.25-3.37), and EBDs risk (aOR = 2.37; 95% CI: 1.37-4.09) compared with non-health peers. Mediation analyses revealed significant indirect effects through self-esteem (aOR = 1.20; 95% CI: 1.03-1.38) and anxiety (aOR = 1.14; 95% CI: 1.01-1.29). : Nursing education was independently associated with a higher risk of EBDs, with statistical mediation analyses indicating that differences in self-esteem and anxiety may help characterize this association. Self-esteem exerted a slightly stronger indirect effect, suggesting that negative self-evaluation may represent a more proximal psychological process rather than a causal determinant.