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Sex Hormones and Incident Heart Failure in Men and Postmenopausal Women: The Atherosclerosis Risk in Communities Study

The journal of clinical endocrinology and metabolism, 2020-10, Vol.105 (10), p.e3798-e3807 [Peer Reviewed Journal]

Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2020 ;Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. ;COPYRIGHT 2020 Oxford University Press ;Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com ;ISSN: 0021-972X ;EISSN: 1945-7197 ;DOI: 10.1210/clinem/dgaa500 ;PMID: 32770207

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Title:
Sex Hormones and Incident Heart Failure in Men and Postmenopausal Women: The Atherosclerosis Risk in Communities Study
Author: Zhao, Di ; Guallar, Eliseo ; Ballantyne, Christie M ; Post, Wendy S ; Ouyang, Pamela ; Vaidya, Dhananjay ; Jia, Xiaoming ; Ying, Wendy ; Subramanya, Vinita ; Ndumele, Chiadi E ; Hoogeveen, Ron C ; Michos, Erin D
Subjects: Aged ; Arteriosclerosis ; Atherosclerosis ; Atherosclerosis - blood ; Atherosclerosis - complications ; Atherosclerosis - epidemiology ; Cardiac output ; Care and treatment ; Congestive heart failure ; Dehydroepiandrosterone ; Dehydroepiandrosterone sulfate ; Dehydroepiandrosterone Sulfate - blood ; Development and progression ; Ejection fraction ; Female ; Follow-Up Studies ; Gender differences ; Globulins ; Health aspects ; Heart failure ; Heart Failure - blood ; Heart Failure - epidemiology ; Heart Failure - etiology ; Heart Failure - physiopathology ; Hormones ; Hormones, Sex ; Humans ; Male ; Middle Aged ; Observations ; Online Only ; Phenotypes ; Post-menopause ; Postmenopause - blood ; Prospective Studies ; Sex differences ; Sex Factors ; Sex factors in disease ; Sex Hormone-Binding Globulin - analysis ; Sex hormones ; Stroke Volume - physiology ; Testosterone ; Testosterone - blood
Is Part Of: The journal of clinical endocrinology and metabolism, 2020-10, Vol.105 (10), p.e3798-e3807
Description: Abstract Context Sex differences exist in heart failure (HF) phenotypes, but there is limited research on the role of sex hormones in HF and its subtypes. Objective To examine the associations of total testosterone, dehydroepiandrosterone sulfate (DHEA-S), and sex hormone-binding globulin (SHBG) with incident HF, HF with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF). Design Atherosclerosis Risk in Communities (ARIC) study (prospective cohort study). Median follow-up is 19.2 years. Setting General community. Participants 4107 men and 4839 postmenopausal women, with mean age of 63.2 (standard deviation [SD] 5.7) and 62.8 (5.5) years, respectively. Exposure Plasma sex hormone levels were measured at visit 4 (1996-1998). Main Outcome Measures Incident HF events were identified through hospital discharge codes and death certificates. Results The Hazard Ratios for HF associated with 1 SD decrease in log-transformed total testosterone, DHEA-S, and SHBG were 1.10 (95% confidence interval 1.03, 1.17), 1.07 (1.00, 1.15), and 1.04 (0.96, 1.11) in men, and 1.05 (0.99, 1.13), 1.17 (1.09, 1.24), and 0.93 (0.85, 1.01) in women, respectively. The associations between sex hormones with subtypes of HF had similar patterns but were attenuated and became statistically insignificant. Conclusion In this prospective cohort, lower levels of endogenous testosterone and DHEA-S in men and DHEA-S in postmenopausal women were associated with the development of HF. Similar directions of association in both sexes and both HF subtypes suggest that sex hormones play a role in the development of HF through common pathways regardless of sex.
Publisher: US: Oxford University Press
Language: English
Identifier: ISSN: 0021-972X
EISSN: 1945-7197
DOI: 10.1210/clinem/dgaa500
PMID: 32770207
Source: Freely Accessible Journals
MEDLINE
Alma/SFX Local Collection

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Sex Hormones and Incident Heart Failure in Men and Postmenopausal Women: The Atherosclerosis Risk in Communities Study

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