Relation of Pregnancy Loss to Risk of Cardiovascular Disease in Parous Postmenopausal Women (From the Women's Health Initiative)

Philip S. Hall, Gregory Nah, Eric Vittinghoff, Donna Parker, Jo Ann E. Manson, Barbara V. Howard, Gloria E. Sarto, Margery L. Gass, Shawnita M. Sealy-Jefferson, Elena Salmoirago-Blotcher, Marcia L. Stefanick, Aladdin H. Shadyab, Linda V. Van Horn, Ki Park, Nisha I. Parikh

Research output: Contribution to journalArticle

Abstract

Women with history of pregnancy loss (PL) have higher burden of cardiovascular disease (CVD) later in life, yet it is unclear whether this is attributable to an association with established CVD risk factors (RFs). We examined whether PL is associated with CVD RFs and biomarkers in parous postmenopausal women in the Women's Health Initiative, and whether the association between PL and CVD RFs accounted for the association between PL and incident CVD. Linear and logistic regressions were used to estimate associations between baseline history of PL and CVD RFs. Cox proportional hazards regression models were used to estimate the associations between baseline history of PL and incident CVD after adjustment for baseline RFs. Of 79,121 women, 27,272 (35%) had experienced PL. History of PL was associated with higher body mass index (p < 0.0001), hypertension (p < 0.0001), diabetes (p = 0.003), depression (p < 0.0001), and lower income (p < 0.0001), physical activity (p = 0.01), poorer diet (p < 0.0001), smoking (p < 0.0001), and alcohol use (p < 0.0001). After adjustment for CVD RFs, PL was significantly associated with incident CVD over mean follow up of 16 years (hazard ratio 1.11, 95% confidence interval 1.06 to 1.16). In conclusion, several CVD RFs are associated with PL, but they do not entirely account for the association between PL and incident CVD.

Original languageEnglish (US)
JournalAmerican Journal of Cardiology
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Women's Health
Cardiovascular Diseases
Pregnancy
Reproductive History
Proportional Hazards Models
Linear Models
Body Mass Index
Biomarkers
Logistic Models
Smoking
Alcohols
Confidence Intervals
Exercise
Depression
Diet
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Relation of Pregnancy Loss to Risk of Cardiovascular Disease in Parous Postmenopausal Women (From the Women's Health Initiative). / Hall, Philip S.; Nah, Gregory; Vittinghoff, Eric; Parker, Donna; Manson, Jo Ann E.; Howard, Barbara V.; Sarto, Gloria E.; Gass, Margery L.; Sealy-Jefferson, Shawnita M.; Salmoirago-Blotcher, Elena; Stefanick, Marcia L.; Shadyab, Aladdin H.; Van Horn, Linda V.; Park, Ki; Parikh, Nisha I.

In: American Journal of Cardiology, 01.01.2019.

Research output: Contribution to journalArticle

Hall, PS, Nah, G, Vittinghoff, E, Parker, D, Manson, JAE, Howard, BV, Sarto, GE, Gass, ML, Sealy-Jefferson, SM, Salmoirago-Blotcher, E, Stefanick, ML, Shadyab, AH, Van Horn, LV, Park, K & Parikh, NI 2019, 'Relation of Pregnancy Loss to Risk of Cardiovascular Disease in Parous Postmenopausal Women (From the Women's Health Initiative)', American Journal of Cardiology. https://doi.org/10.1016/j.amjcard.2019.02.012
Hall, Philip S. ; Nah, Gregory ; Vittinghoff, Eric ; Parker, Donna ; Manson, Jo Ann E. ; Howard, Barbara V. ; Sarto, Gloria E. ; Gass, Margery L. ; Sealy-Jefferson, Shawnita M. ; Salmoirago-Blotcher, Elena ; Stefanick, Marcia L. ; Shadyab, Aladdin H. ; Van Horn, Linda V. ; Park, Ki ; Parikh, Nisha I. / Relation of Pregnancy Loss to Risk of Cardiovascular Disease in Parous Postmenopausal Women (From the Women's Health Initiative). In: American Journal of Cardiology. 2019.
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abstract = "Women with history of pregnancy loss (PL) have higher burden of cardiovascular disease (CVD) later in life, yet it is unclear whether this is attributable to an association with established CVD risk factors (RFs). We examined whether PL is associated with CVD RFs and biomarkers in parous postmenopausal women in the Women's Health Initiative, and whether the association between PL and CVD RFs accounted for the association between PL and incident CVD. Linear and logistic regressions were used to estimate associations between baseline history of PL and CVD RFs. Cox proportional hazards regression models were used to estimate the associations between baseline history of PL and incident CVD after adjustment for baseline RFs. Of 79,121 women, 27,272 (35{\%}) had experienced PL. History of PL was associated with higher body mass index (p < 0.0001), hypertension (p < 0.0001), diabetes (p = 0.003), depression (p < 0.0001), and lower income (p < 0.0001), physical activity (p = 0.01), poorer diet (p < 0.0001), smoking (p < 0.0001), and alcohol use (p < 0.0001). After adjustment for CVD RFs, PL was significantly associated with incident CVD over mean follow up of 16 years (hazard ratio 1.11, 95{\%} confidence interval 1.06 to 1.16). In conclusion, several CVD RFs are associated with PL, but they do not entirely account for the association between PL and incident CVD.",
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AU - Nah, Gregory

AU - Vittinghoff, Eric

AU - Parker, Donna

AU - Manson, Jo Ann E.

AU - Howard, Barbara V.

AU - Sarto, Gloria E.

AU - Gass, Margery L.

AU - Sealy-Jefferson, Shawnita M.

AU - Salmoirago-Blotcher, Elena

AU - Stefanick, Marcia L.

AU - Shadyab, Aladdin H.

AU - Van Horn, Linda V.

AU - Park, Ki

AU - Parikh, Nisha I.

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N2 - Women with history of pregnancy loss (PL) have higher burden of cardiovascular disease (CVD) later in life, yet it is unclear whether this is attributable to an association with established CVD risk factors (RFs). We examined whether PL is associated with CVD RFs and biomarkers in parous postmenopausal women in the Women's Health Initiative, and whether the association between PL and CVD RFs accounted for the association between PL and incident CVD. Linear and logistic regressions were used to estimate associations between baseline history of PL and CVD RFs. Cox proportional hazards regression models were used to estimate the associations between baseline history of PL and incident CVD after adjustment for baseline RFs. Of 79,121 women, 27,272 (35%) had experienced PL. History of PL was associated with higher body mass index (p < 0.0001), hypertension (p < 0.0001), diabetes (p = 0.003), depression (p < 0.0001), and lower income (p < 0.0001), physical activity (p = 0.01), poorer diet (p < 0.0001), smoking (p < 0.0001), and alcohol use (p < 0.0001). After adjustment for CVD RFs, PL was significantly associated with incident CVD over mean follow up of 16 years (hazard ratio 1.11, 95% confidence interval 1.06 to 1.16). In conclusion, several CVD RFs are associated with PL, but they do not entirely account for the association between PL and incident CVD.

AB - Women with history of pregnancy loss (PL) have higher burden of cardiovascular disease (CVD) later in life, yet it is unclear whether this is attributable to an association with established CVD risk factors (RFs). We examined whether PL is associated with CVD RFs and biomarkers in parous postmenopausal women in the Women's Health Initiative, and whether the association between PL and CVD RFs accounted for the association between PL and incident CVD. Linear and logistic regressions were used to estimate associations between baseline history of PL and CVD RFs. Cox proportional hazards regression models were used to estimate the associations between baseline history of PL and incident CVD after adjustment for baseline RFs. Of 79,121 women, 27,272 (35%) had experienced PL. History of PL was associated with higher body mass index (p < 0.0001), hypertension (p < 0.0001), diabetes (p = 0.003), depression (p < 0.0001), and lower income (p < 0.0001), physical activity (p = 0.01), poorer diet (p < 0.0001), smoking (p < 0.0001), and alcohol use (p < 0.0001). After adjustment for CVD RFs, PL was significantly associated with incident CVD over mean follow up of 16 years (hazard ratio 1.11, 95% confidence interval 1.06 to 1.16). In conclusion, several CVD RFs are associated with PL, but they do not entirely account for the association between PL and incident CVD.

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