It’s a question most women have never been asked by a cardiologist. After all, it seems like it would be irrelevant to heart health. At what age did you begin menstruating?

But researchers at the University of Florida and Cedars-Sinai Medical Center in Los Angeles hope the question for women patients will become as common as asking if they smoke or have high blood pressure.

The researchers examined data from participants in the Women’s Ischemia [is-KEY-mia] Syndrome Evaluation, a multicenter collaboration begun in 1997. They found that women whose age of first menstruation comes earlier or later than the U.S. average of 12 years have a heightened risk of cardiac problems. These include heart attack, stroke, heart failure and death.

Participants, who were tracked for about six years, had symptoms of heart disease serious enough to require a coronary angiography, a test to determine if blood flow to the heart is restricted. Their median age was 57 years.

Women whose first menstruation was at age 10 or younger faced a four-fold increase in risk. At age 15 or higher, the risk was elevated two-and-a-half times. For other ages — 11, 13 and 14 — the hazard was at least two-times higher.

Why the age of first menstruation plays a role in cardiac risk remains unclear, although one hypothesis is focused on genetic variables.

The scientists hope to draw physicians’ attention to this novel risk factor. Also, if a woman knows the age of her first menstruation puts her at higher risk of heart disease, she might address the issue with her physician.

So, if a physician does pose the question to you, don’t be taken aback. They’re getting to the heart of the matter.