News | History of Infertility May Signal Higher Heart Failure Risk: U.S. Study Finds New Link Between Reproductive and Cardiovascular Health
A cardiology research team at Massachusetts General Hospital (MGH) found that women with a history of infertility had a 16% higher risk of developing heart failure than women without infertility. Published recently in the Journal of the American College of Cardiology, the study highlights the importance of reproductive history to women's later cardiovascular health.
“We are increasingly recognizing that a woman's reproductive experiences provide important clues about her future heart disease risk. Difficulty conceiving, events during pregnancy, and the timing of menopause are all closely related to health later in life,” said Dr. Emily Lau, the study's lead author and director of the Menopause and Cardiovascular Clinic at MGH.
Strongest Association With the Type of Heart Failure Most Common in Women
The research team analyzed data from the Women's Health Initiative (WHI), which began in the 1990s and documented reproductive and health information from tens of thousands of postmenopausal women. This study included 38,528 participants, about 14% of whom reported a history of infertility. Researchers followed the women for up to 15 years to determine whether they developed heart failure (HF).
Heart failure is divided into two types:
Heart failure with preserved ejection fraction (HFpEF): the heart's pumping function is normal, but its ability to relax is impaired. This is the most common type in women;
Heart failure with reduced ejection fraction (HFrEF): the heart's pumping capacity is impaired.
A history of infertility was associated with a 16% higher overall risk of heart failure and was particularly strongly associated with HFpEF, for which the risk was 27% higher. This association was unaffected by whether a woman ultimately became pregnant or gave birth.
Cause Remains Unknown; Reproductive History Should Be Included in Cardiovascular Risk Screening
HFpEF has become the predominant type of heart failure in the United States in recent years, but its pathophysiology remains unclear. Dr. Lau noted, “HFpEF is more common in women, and women with infertility are more likely to develop HFpEF. This suggests we should look for answers in women's earlier reproductive experiences.”
Previous studies suggested that women with infertility may have more cardiometabolic risk factors, such as hypertension and high cholesterol. In this study, however, these conventional risk factors did not explain the strong association between infertility and heart failure. The team also analyzed other conditions related to infertility, including thyroid disorders, irregular menstruation, and early menopause, but none appeared to be the primary explanation.
“This raises a key question: what mechanism drives the association between infertility and heart failure?” said Dr. Lau. Endothelial dysfunction and inflammation may play a role, but further confirmation is needed.
The team plans prospective studies of vascular function, exercise performance, and metabolic status in these women to clarify the biological pathways linking infertility and heart failure.
Call to Include Reproductive History in Cardiovascular Risk Assessment
The researchers emphasized that clinicians rarely consider a woman's reproductive history systematically when assessing cardiovascular risk, including infertility, pregnancy complications, and timing of menopause. These factors may provide important clues for early screening.
“Although we cannot change whether a woman experienced infertility, we can use that information to develop a more proactive heart-health strategy, such as managing blood pressure and cholesterol and stopping smoking,” said Dr. Lau.
The study's corresponding author was Dr. Jennifer Ho. The study was supported in part by the National Institutes of Health (NIH) and the American Heart Association (AHA).
News | History of Infertility May Signal Higher Heart Failure Risk: U.S. Study Finds New Link Between Reproductive and Cardiovascular Health
News | History of Infertility May Signal Higher Heart Failure Risk: U.S. Study Finds New Link Between Reproductive and Cardiovascular Health
A cardiology research team at Massachusetts General Hospital (MGH) found that women with a history of infertility had a 16% higher risk of developing heart failure than women without infertility. Published recently in the Journal of the American College of Cardiology, the study highlights the importance of reproductive history to women's later cardiovascular health.
“We are increasingly recognizing that a woman's reproductive experiences provide important clues about her future heart disease risk. Difficulty conceiving, events during pregnancy, and the timing of menopause are all closely related to health later in life,” said Dr. Emily Lau, the study's lead author and director of the Menopause and Cardiovascular Clinic at MGH.
Strongest Association With the Type of Heart Failure Most Common in Women
The research team analyzed data from the Women's Health Initiative (WHI), which began in the 1990s and documented reproductive and health information from tens of thousands of postmenopausal women. This study included 38,528 participants, about 14% of whom reported a history of infertility. Researchers followed the women for up to 15 years to determine whether they developed heart failure (HF).
Heart failure is divided into two types:
Heart failure with preserved ejection fraction (HFpEF): the heart's pumping function is normal, but its ability to relax is impaired. This is the most common type in women;
Heart failure with reduced ejection fraction (HFrEF): the heart's pumping capacity is impaired.
A history of infertility was associated with a 16% higher overall risk of heart failure and was particularly strongly associated with HFpEF, for which the risk was 27% higher. This association was unaffected by whether a woman ultimately became pregnant or gave birth.
Cause Remains Unknown; Reproductive History Should Be Included in Cardiovascular Risk Screening
HFpEF has become the predominant type of heart failure in the United States in recent years, but its pathophysiology remains unclear. Dr. Lau noted, “HFpEF is more common in women, and women with infertility are more likely to develop HFpEF. This suggests we should look for answers in women's earlier reproductive experiences.”
Previous studies suggested that women with infertility may have more cardiometabolic risk factors, such as hypertension and high cholesterol. In this study, however, these conventional risk factors did not explain the strong association between infertility and heart failure. The team also analyzed other conditions related to infertility, including thyroid disorders, irregular menstruation, and early menopause, but none appeared to be the primary explanation.
“This raises a key question: what mechanism drives the association between infertility and heart failure?” said Dr. Lau. Endothelial dysfunction and inflammation may play a role, but further confirmation is needed.
The team plans prospective studies of vascular function, exercise performance, and metabolic status in these women to clarify the biological pathways linking infertility and heart failure.
Call to Include Reproductive History in Cardiovascular Risk Assessment
The researchers emphasized that clinicians rarely consider a woman's reproductive history systematically when assessing cardiovascular risk, including infertility, pregnancy complications, and timing of menopause. These factors may provide important clues for early screening.
“Although we cannot change whether a woman experienced infertility, we can use that information to develop a more proactive heart-health strategy, such as managing blood pressure and cholesterol and stopping smoking,” said Dr. Lau.
The study's corresponding author was Dr. Jennifer Ho. The study was supported in part by the National Institutes of Health (NIH) and the American Heart Association (AHA).
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