Abstract:
BACKGROUND:Reproductive factors reflective of endogenous sex hormone exposure might have an effect on cardiac remodeling and the development of heart failure (HF). OBJECTIVES:This study examined the association between key reproductive factors and the incidence of HF. METHODS:Women from a cohort of the Women's Health Initiative were systematically evaluated for the incidence of HF hospitalization from study enrollment through 2014. Reproductive factors (number of live births, age at first pregnancy, and total reproductive duration [time from menarche to menopause]) were self-reported at study baseline in 1993 to 1998. We employed Cox proportional hazards regression analysis in age- and multivariable-adjusted models. RESULTS:Among 28,516 women, with an average age of 62.7 ± 7.1 years at baseline, 1,494 (5.2%) had an adjudicated incident HF hospitalization during an average follow-up of 13.1 years. After adjusting for covariates, total reproductive duration in years was inversely associated with incident HF: hazard ratios (HRs) of 0.99 per year (95% confidence interval [CI]: 0.98 to 0.99 per year) and 0.95 per 5 years (95% CI: 0.91 to 0.99 per 5 years). Conversely, early age at first pregnancy and nulliparity were significantly associated with incident HF in age-adjusted models, but not after multivariable adjustment. Notably, nulliparity was associated with incident HF with preserved ejection fraction in the fully adjusted model (HR: 2.75; 95% CI: 1.16 to 6.52). CONCLUSIONS:In post-menopausal women, shorter total reproductive duration was associated with higher risk of incident HF, and nulliparity was associated with higher risk for incident HF with preserved ejection fraction. Whether exposure to endogenous sex hormones underlies this relationship should be investigated in future studies.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Hall PS,Nah G,Howard BV,Lewis CE,Allison MA,Sarto GE,Waring ME,Jacobson LT,Manson JE,Klein L,Parikh NIdoi
10.1016/j.jacc.2017.03.557subject
Has Abstractpub_date
2017-05-23 00:00:00pages
2517-2526issue
20eissn
0735-1097issn
1558-3597pii
S0735-1097(17)36769-4journal_volume
69pub_type
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journal_title:Journal of the American College of Cardiology
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abstract::Twenty-five patients with aortic insufficiency and eight asymptomatic control subjects underwent radionuclide ventriculography at rest and during dynamic and isometric exercise to clarify the mechanisms for preservation of exercise capacity in aortic insufficiency. Regardless of symptomatic state or severity of regurg...
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更新日期:2008-07-15 00:00:00
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