Thanks to research developed by a team of scientists from the Massachusetts General Hospital (MGH), it was possible to observe that women affected by infertility have a 16% increased risk of contracting anheart failure compared to women who did not have such a diagnosis.
The results of the study have been published in the scientific journal Journal of the American College of Cardiology.
Infertility linked to heart failure: here’s what the research says
“We are beginning to recognize that a woman’s reproductive history says a lot about her future risk of heart disease “Declared the first author Emily Lau, cardiologist and director of the Menopause, Hormones and Cardiovascular Clinic at MGH: “If a woman has difficulty getting pregnant, what happens during her pregnancies, when she goes through menopause, everything affects her risk of incurring heart disease over the years “.
Infertility affects about 1 in 5 women in the United States and includes a spectrum of difficulty conceiving, but its link to heart failure has not been delineated to date. In collaboration with the Women’s Health Initiative (WHI), which was designed in the early 1990s and questioned a woman’s reproductive history, Lau and colleagues studied postmenopausal women from the WHI and examined whether difficulty conceiving was associated with the development of heart failure.
There are two types of heart failure: heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Ejection fraction is a measure related to the percentage by volume of blood that is pumped from the left ventricle of the heart during each beat. An ejection fraction of less than 50% is commonly seen as abnormal or reduced.
The panel found an association between infertility and general heart failure, particularly with HFpEF, a form of heart failure that is much more common in women regardless of fertility history.
Of the 38,528 postmenopausal women studied, 14% of participants reported a history of conception difficulties. Over a 15-year follow-up period, the researchers noted that infertility was associated with a 16% future risk of overall heart failure. When they looked at heart failure subtypes, they found that difficulty conceiving was associated with a 27% increase in future HFpEF risk.
Over the past decade, HFpEF (where the heart muscle doesn’t relax well) as opposed to HFrEF (where the left ventricle doesn’t pump well), has become the dominant form of heart failure in both men and women. But it remains more common in women. “It is a difficult condition because we still do not fully understand how HFpEF develops and we do not have excellent therapies to treat HFpEF.Lau said.
“I think our findings are particularly noteworthy because heart failure with preserved ejection fraction is more prevalent in women.“, Lau added. “We don’t understand why we see more HFpEF in women. Looking back into a woman’s early reproductive life can give us some clues as to why “. Of note, the team observed that the link persisted regardless of whether an individual eventually conceived or had a live birth.
The increased risk is independent of traditional cardiovascular risk factors and other conditions related to the difficulty of getting pregnant: “In previous studies it has been suggested that women with infertility have multiple cardiometabolic risk factorsLau explained, but the team did not find that cardiometabolic risk factors explained the link between infertility and heart failure in this study.
The researchers also sought to understand whether other infertility-related conditions such as thyroid disease, irregular menstruation and early menopause explained the association between infertility and heart failure, but they haven’t even been shown to support that hypothesis.
“So the question really arises: what are the mechanisms that drive the association between infertility and heart failure? ” says Lau. Are they shared risk factors or is infertility on the causal path? She mentions that vascular and endothelial dysfunction may be involved and plans to eventually clarify the mechanism underlying the link between infertility and heart failure. In the future, Lau hopes to conduct a prospective study of women with a history of infertility involving exercise parameters, vascular measures, and more to solve the mystery.“.
“We as scientists and doctors are beginning to recognize how important a woman’s reproductive history is to her future risk of heart disease. Infertility is one of many cardiovascular risk factors, such as hypertension and high blood pressure, but reproductive history is not routinely considered as part of cardiovascular risk assessment“Says Lau.
Because people don’t tend to develop heart failure until age 60 and beyond, and difficulty conceiving is mostly experienced in their 20s, 30s, and 40s, many doctors don’t think about the connection. “We cannot change a woman’s infertility history, but if we know that a woman has had a history of infertility, we can be more aggressive in advising her on other modifiable risk factors including hypertension, high cholesterol, smoking and more “concluded the scientist.
#Infertility #increases #risk #developing #heart #failure