Sex hormones and incident heart failure in men and postmenopausal women: The atherosclerosis risk in communities study

Di Zhao, Eliseo Guallar, Christie M. Ballantyne, Wendy S. Post, Pamela Ouyang, Dhananjay Vaidya, Xiaoming Jia, Wendy Ying, Vinita Subramanya, Chiadi E. Ndumele, Ron C. Hoogeveen, Erin D. Michos

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Context: Sex differences exist in heart failure (HF) phenotypes, but there is limited research on the role of sex hormones in HF and its subtypes. Objective: To examine the associations of total testosterone, dehydroepiandrosterone sulfate (DHEA-S), and sex hormone-binding globulin (SHBG) with incident HF, HF with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF). Design: Atherosclerosis Risk in Communities (ARIC) study (prospective cohort study). Median follow-up is 19.2 years. Setting: General community. Participants: 4107 men and 4839 postmenopausal women, with mean age of 63.2 (standard deviation [SD] 5.7) and 62.8 (5.5) years, respectively. Exposure: Plasma sex hormone levels were measured at visit 4 (1996-1998). Main Outcome Measures: Incident HF events were identified through hospital discharge codes and death certificates. Results: The Hazard Ratios for HF associated with 1 SD decrease in log-transformed total testosterone, DHEA-S, and SHBG were 1.10 (95% confidence interval 1.03, 1.17), 1.07 (1.00, 1.15), and 1.04 (0.96, 1.11) in men, and 1.05 (0.99, 1.13), 1.17 (1.09, 1.24), and 0.93 (0.85, 1.01) in women, respectively. The associations between sex hormones with subtypes of HF had similar patterns but were attenuated and became statistically insignificant. Conclusion: In this prospective cohort, lower levels of endogenous testosterone and DHEA-S in men and DHEA-S in postmenopausal women were associated with the development of HF.

play a role in the development of HF through common pathways regardless of sex.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume105
Issue number10
DOIs
StatePublished - Oct 1 2020

Keywords

  • DHEA-S
  • HFpEF
  • HFrEF
  • Heart failure
  • SHBG
  • Sex hormone
  • Testosterone

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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