Study links history of infertility in women to increased risk of heart failure later in life

Older woman receives blood pressure check from a healthcare worker.

A history of infertility is associated with an increased risk of heart failure later in life, according to a large observational study in postmenopausal women.   

Infertility affects about 1 in 5 women in the United States, but its link to heart failure has not been well-studied until recently, researchers say. The new study analyzed data from over 38,000 postmenopausal women enrolled in the NHLBI’s Women’s Health Initiative, a long-term national health study that focuses on strategies for preventing heart disease, breast and colorectal cancer, and osteoporosis in postmenopausal women. The study also tracked data on a woman’s reproductive history.    
About 14% of the study participants reported a history of infertility. Over a 15-year follow-up period, the researchers found that having a history of infertility was associated with a 16% increased future risk of heart failure overall, when compared to women who did not experience infertility during this period.  When looking at heart failure subtypes, they found that Infertility was linked to a 27% increase in future risk of heart failure with preserved ejection fraction (HFpEF), a type of heart failure more commonly found in women. HFpEF has few effective treatment options, the researchers noted  

The mechanisms behind this link are unclear and warrant further study, the researchers said. Now that a strong link between infertility and future risk of heart diseases has been identified, doctors may consider more aggressive counseling for these women, particularly for modifiable risk factors like high blood pressure, high cholesterol, smoking, and other factors, the investigators noted.  

The study, funded in part by the NHLBI, appeared in the Journal of the American College of Cardiology.

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Diagnostic and Interventional Cardiology
Massachusetts General Hospital press release