Fewer Menstrual Cycles May Lead to Increased Risk for Heart Failure

HF linked to the number of menstrual cycles experienced.
HF linked to the number of menstrual cycles experienced.
The fewer menstrual cycles women had over a lifetime placed them at greater risk for incident heart failure.

Women who had fewer menstrual cycles were at a greater risk for incident heart failure, according to recent research published in the Journal of the American College of Cardiology.

“Heart disease is the leading cause of death among women, and we are still learning what factors contribute to women’s risk of developing heart disease,” Phillip S. Hall, MD, from the division of cardiology at the University of California, San Francisco, told Endocrinology Advisor in an interview.

Dr Hall and fellow researchers evaluated 28,516 women (average age, 62.7±7.1 years) from the Women’s Health Initiative (WHI) between 1993 and 2014. They recorded details about their age during their first pregnancy, number of live births, and total number of menstrual cycles. Incident heart failure cases were document during a 13.1-year follow-up period.

“In our research focusing on key reproductive factors and the development of heart failure in 28,516 women in the WHI, we found that the longer that women continued to have menstrual cycles, the lower their risk of developing heart failure,” Dr Hall told Endocrinology Advisor.

A total of 1494 women (5.2%) were hospitalized for adjudicated incident heart failure, with women who had fewer total menstrual cycles having a greater risk for incident heart failure at 1 year (hazard ratio [HR] 0.99; 95% CI, 0.98-0.99) and 5 years (HR 0.95; 95% CI, 0.91-0.99).

Age-adjusted models showed nulliparity and age at first pregnancy were significantly associated with incident heart failure, while a fully-adjusted model showed nulliparity was associated with incident heart failure with preserved ejection fraction (HR 2.75; 95% CI, 1.16-6.52).

“Both of these findings represent important associations between reproductive factors and cardiovascular disease that need to be corroborated in other studies and explored further in future research,” Dr Hall told Endocrinology Advisor. “We couldn’t fully address the reasons behind the associations, and we believe future studies are needed to explore potential mechanisms.”

Dr Hall and fellow researchers noted that a future goal of their research is to help clinicians treat heart disease risk factors such as high blood pressure, smoking, diabetes, and high cholesterol.

“By continuing to investigate the factors that affect women’s risk of developing heart disease, we hope to help all healthcare providers who take care of women better understand how to assess their patients’ risk and to provide counseling and risk factor modification,” Dr Hall told Endocrinology Advisor.

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Hall PS, Nah G, Howard BV, et al. Reproductive factors and incidence of heart failure hospitalization in the Women’s Health Initiative. J Am Coll Cardiol. 2017;69(20):2517-2526. doi:10.1016/j.jacc.2017.03.557