Journal article
Pregnancy-related events associated with subclinical cardiovascular disease burden in late midlife: SWAN
Atherosclerosis, Vol.289, pp.27-35
10/01/2019
DOI: 10.1016/j.atherosclerosis.2019.07.012
PMCID: PMC6952268
PMID: 31446211
Abstract
Background and aims: Reproductive factors are associated with later life CVD in women (e.g., age at first birth, preeclampsia, gestational diabetes), but studies have focused largely on premenopausal women. We examined the relationship of reproductive factors with subclinical CVD burden in late midlife women.
Methods: We included 964 parous women from the Study of Women's Health Across the Nation (SWAN), who completed a reproductive history questionnaire at the 13th SWAN visit (2011-2012), and a carotid ultrasound and brachial-ankle pulse wave velocity (baPWV) assessment. The primary outcomes were carotid intima-media thickness, plaque, and baPWV; our secondary outcome was a composite subclinical CVD index created using these measures. Linear and logistic regression was performed to examine associations with individual subclinical CVD measures, and multinomial logistic regression was used in analyses of the composite index. Models adjusted for socio-demographics and cardiovascular risk factors.
Results: Mean age at subclinical CVD assessment was 60.2 years (SD +/- 2.7). History of gestational hypertension/preeclampsia was associated with greater carotid IMT (beta: 0.038, p = 0.004). Earlier age at first birth was associated with subclinical CVD, but not when accounting for CVD risk factors. History of gestational diabetes was associated with greater baPWV, but not related to our composite index.
Conclusions: Pregnancy history is an important marker of subclinical CVD in late midlife and may impact the vasculature through distinct pathways. Future studies are necessary to evaluate racial/ethnic differences in the observed associations and to assess the benefit of a composite subclinical CVD index for earlier CVD risk modification in midlife women.
Details
- Title: Subtitle
- Pregnancy-related events associated with subclinical cardiovascular disease burden in late midlife: SWAN
- Creators
- Yamnia I. Cortes - University of North Carolina at Chapel HillJanet M. Catov - Magee-Womens Research InstituteMaria Brooks - University of PittsburghSamar R. El Khoudary - University of PittsburghRebecca C. Thurston - University of PittsburghKaren A. Matthews - University of PittsburghCarmen R. Isasi - Albert Einstein College of MedicineElizabeth A. Jackson - University of Alabama at BirminghamEmma Barinas-Mitchell - University of Pittsburgh
- Resource Type
- Journal article
- Publication Details
- Atherosclerosis, Vol.289, pp.27-35
- DOI
- 10.1016/j.atherosclerosis.2019.07.012
- PMID
- 31446211
- PMCID
- PMC6952268
- NLM abbreviation
- Atherosclerosis
- ISSN
- 0021-9150
- eISSN
- 1879-1484
- Publisher
- Elsevier
- Number of pages
- 9
- Grant note
- T32 HL083825 / Cardiovascular Epidemiology Training Program at the University of Pittsburgh Graduate School of Public Health U01AG012531 / NATIONAL INSTITUTE ON AGING; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA) National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA) National Institute of Nursing Research (NINR); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Nursing Research (NINR) U01NR004061 / NATIONAL INSTITUTE OF NURSING RESEARCH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Nursing Research (NINR) T32HL083825 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) U01NR004061; U01AG012505; U01AG012535; U01AG012531; U01AG012539; U01AG012546; U01AG012553; U01AG012554; U01AG012495 / NIH Office of Research on Women's Health (ORWH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 10/01/2019
- Academic Unit
- Nursing
- Record Identifier
- 9984446459502771
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