000			03742nam a22003377a 4500
008			170526s20172017 xxu||||| |||| 00| 0 eng d
022			_a0735-1097
040			_aOvid MEDLINE(R)
099			_a28521890
245			_aReproductive Factors and Incidence of Heart Failure Hospitalization in the Women's Health Initiative.
251			_aJournal of the American College of Cardiology. 69(20):2517-2526, 2017 May 23
252			_aJ Am Coll Cardiol. 69(20):2517-2526, 2017 May 23
253			_aJournal of the American College of Cardiology
260			_c2017
260			_fFY2017
266			_d2017-05-26
501			_aAvailable 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
520			_aBACKGROUND: Reproductive factors reflective of endogenous sex hormone exposure might have an effect on cardiac remodeling and the development of heart failure (HF).
520			_aCONCLUSIONS: 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.
520			_aCopyright (c) 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
520			_aMETHODS: 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.
520			_aOBJECTIVES: This study examined the association between key reproductive factors and the incidence of HF.
520			_aRESULTS: 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).
546			_aEnglish
651			_aMedStar Health Research Institute
657			_aJournal Article
700			_aHoward, Barbara V
790			_aAllison MA, Hall PS, Howard BV, Jacobson LT, Klein L, Lewis CE, Manson JE, Nah G, Parikh NI, Sarto GE, Waring ME
856			_uhttps://dx.doi.org/10.1016/j.jacc.2017.03.557 _zhttps://dx.doi.org/10.1016/j.jacc.2017.03.557
942			_cART _dArticle
999			_c2575 _d2575