Menstrual and reproductive risk factors for ischemic heart disease
Menstrual and reproductive risk factors for ischemic heart disease
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DOI：
10.1097/00001648-199905000-00011
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发表时间：
1999-05-01
期刊：
影响因子：
5.4
通讯作者：
Sandler, DP
中科院分区：
文献类型：
--
作者：
Cooper, GS;Ephross, SA;Sandler, DP
激素在缺血性心脏病中的作用引起了相当大的兴趣，但与内源性激素相关的危险因素相关的数据有限。我们研究了867名受过大学教育的白人女性的月经和生殖因素与缺血性心脏病之间的关系，这些女性从20岁出头到更年期至少记录了5年的月经周期数据。在平均年龄73岁时，通过自我填写（N = 714）或代理填写（N = 153）问卷获得缺血性心脏病病史。该分析包括44,899人年的随访和45例心肌梗死、血管成形术、心脏搭桥手术或缺血性心脏病相关死亡。缺血性心脏病风险随着初潮年龄的增加而降低（经年龄调整的RR为每年0.76,95% CI = 0.60-0.95）。考虑到28-32岁的月经周期特征，与长度、变异性或出血持续时间的总体关联不大。初产年龄越晚（33-43岁的年龄校正RR为2.90,25-29岁的年龄校正RR为2.90）和末产年龄越晚（40岁以上的年龄校正RR为3.79,35-39岁的年龄校正RR为3.79），缺血性心脏病风险增加，但与高胎次相关性不大。
The role of hormones in ischemic heart disease is of considerable interest, but limited data are available pertaining to risk factors associated with endogenous hormones. We examined the association between menstrual and reproductive factors and ischemic heart disease in a cohort of 867 white, college-educated women who prospectively recorded menstrual cycle data for at least 5 years from their early 20s through their menopause. Ischemic heart disease history was obtained from a self-administered (N = 714) or proxy-administered (N = 153) questionnaire completed at a mean age of 73 years. The analysis included 44,899 person-years of follow-up and 45 cases of myocardial infarction, angioplasty, heart bypass surgery, or ischemic heart disease-related mortality. Ischemic heart disease risk decreased with increasing age at menarche (age-adjusted RR 0.76 per year, 95% CI = 0.60-0.95). Considering menstrual cycle characteristics ages 28-32, there was little overall association with length, variability, or bleeding duration. Ischemic heart disease risk increased with later age at first birth (age adjusted RR 2.90 for ages 33-43 compared with 25-29) and later age at last birth (age adjusted RR 3.79 for ages greater than or equal to 40 compared with 35-39), but there was little association with high parity.