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Reproductive Factors and Incidence of Heart Failure Hospitalization in the Women’s Health Initiative

Journal of the American College of Cardiology, 2017-05, Vol.69 (20), p.2517-2526 [Peer Reviewed Journal]

American College of Cardiology Foundation ;2017 American College of Cardiology Foundation ;Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited May 23, 2017 ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2017.03.557 ;PMID: 28521890

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Title:
Reproductive Factors and Incidence of Heart Failure Hospitalization in the Women’s Health Initiative
Author: Hall, Philip S., MD ; Nah, Gregory, MA ; Howard, Barbara V., PhD ; Lewis, Cora E., MD, MSPH ; Allison, Matthew A., MD, MPH ; Sarto, Gloria E., MD, PhD ; Waring, Molly E., PhD ; Jacobson, Lisette T., PhD, MPA, MA ; Manson, JoAnn E., MD, DrPH ; Klein, Liviu, MD, MS ; Parikh, Nisha I., MD, MPH
Subjects: Adjustment ; Age ; Aged ; Cardiovascular ; cardiovascular disease ; Cohort Studies ; Confidence intervals ; Exposure ; Female ; Gonadal Steroid Hormones - metabolism ; Hazards ; Health risk assessment ; Health risks ; Heart ; Heart diseases ; Heart failure ; Heart Failure - diagnosis ; Heart Failure - epidemiology ; Heart Failure - metabolism ; Hormones ; Hospitalization ; Hospitalization - statistics & numerical data ; Humans ; Incidence ; Internal Medicine ; Menarche ; Menarche - metabolism ; Menopause ; Middle Aged ; Postmenopause - metabolism ; Pregnancy ; Regression analysis ; Reproduction ; Reproductive History ; Risk Factors ; Sex ; Sex hormones ; Statistics as Topic ; Stroke Volume - physiology ; United States - epidemiology ; Ventricular Remodeling - physiology ; Women ; Women's Health ; Womens health
Is Part Of: Journal of the American College of Cardiology, 2017-05, Vol.69 (20), p.2517-2526
Description: 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.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0735-1097
EISSN: 1558-3597
DOI: 10.1016/j.jacc.2017.03.557
PMID: 28521890
Source: GFMER Free Medical Journals
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Reproductive Factors and Incidence of Heart Failure Hospitalization in the Women’s Health Initiative

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