Infertility ups risk of heart failure in women

A history of infertility among women appears to contribute to an increased risk of incident heart failure (HF), reveals a recent study.

Such association is driven by a greater risk of HF with preserved ejection fraction (HFpEF), but not HF with reduced ejection fraction (HFrEF), independent of traditional cardiovascular risk factors and other infertility-related conditions, according to the researchers.

This study aimed to investigate the development of HF and its subtypes among women with and without a history of infertility. The researchers prospectively followed postmenopausal women from the Women’s Health Initiative. Infertility was self-reported at baseline.

The association of infertility with incident overall HF and HF subtypes (HFpEF: left ventricular ejection fraction of ≥50 percent vs HFrEF: left ventricular ejection fraction <50 percent) were assessed using multivariable cause-specific Cox models.

A total of 38,528 postmenopausal women (mean age 63 years) were included, of whom 5,399 (14 percent) reported a history of infertility. Incident HF occurred in 2,373 women, including 807 with HFrEF and 1,133 with HFpEF, over a median follow-up of 15 years.

Infertility independently correlated with future risk of overall HF (hazard ratio [HR], 1.16, 95 percent confidence interval [CI], 1.04‒1.30; p=0.006). When examining HF subtypes, however, infertility only significantly correlated with future risk of HFpEF (HR, 1.27, 95 percent CI, 1.09‒1.48; p=0.002) but not with HFrEF (HR, 0.97, 95 percent CI, 0.80‒1.18).

“Future research should investigate mechanisms that underlie the link between infertility and HFpEF,” the researchers said.