Citation: Journal of the American College of Cardiology. 69(20):2517-2526, 2017 May 23.Journal: Journal of the American College of Cardiology.Published: 2017ISSN: 0735-1097.Full author list: Hall PS; Nah G; Howard BV; Lewis CE; Allison MA; Sarto GE; Waring ME; Jacobson LT; Manson JE; Klein L; Parikh NI.UI/PMID: 28521890.Institution(s): MedStar Health Research InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access onlineDigital Object Identifier: https://dx.doi.org/10.1016/j.jacc.2017.03.557 (Click here)Abbreviated citation: J Am Coll Cardiol. 69(20):2517-2526, 2017 May 23.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007MH - AgedMH - Cohort StudiesMH - FemaleMH - Gonadal Steroid Hormones/me [Metabolism]MH - Heart Failure/di [Diagnosis]MH - Heart Failure/ep [Epidemiology]MH - Heart Failure/me [Metabolism]MH - *Heart FailureMH - *Hospitalization/sn [Statistics & Numerical Data]MH - HumansMH - IncidenceMH - Menarche/me [Metabolism]MH - Middle AgedMH - Postmenopause/me [Metabolism]MH - *Reproductive HistoryMH - Risk FactorsMH - Statistics as TopicMH - Stroke Volume/ph [Physiology]MH - United States/ep [Epidemiology]MH - *Ventricular Remodeling/ph [Physiology]MH - Women's Health.Abstract: BACKGROUND: Reproductive factors reflective of endogenous sex hormone exposure might have an effect on cardiac remodeling and the development of heart failure (HF).Abstract: OBJECTIVES: This study examined the association between key reproductive factors and the incidence of HF.Abstract: 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.Abstract: 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).Abstract: 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.Abstract: Copyright (c) 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.