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Reproductive factors in women linked to increased risk of cardiovascular disease, study finds

An earlier first birth, a higher number of live births, and starting periods at a younger age are all linked to a higher risk of heart and circulatory problems in women, according to new research part-funded by us.

A woman who is pregnant

The study, led by Imperial College London researchers, provides evidence for a causal relationship between female reproductive factors and a range of heart and circulatory diseases, including atrial fibrillation (irregular heart rate), coronary heart disease, heart failure, and stroke.

The researchers hope it will help doctors to better understand and monitor women’s risk factors and intervene where appropriate.

Finding a genetic connection

Researchers analysed genetic data linked to women's age at first birth, their number of live births, their age at their first period, and their age at menopause. They looked at previous studies involving more than 100,000 women.

By using a statistical technique called Mendelian Randomization, the researchers were able to show a link between the genes that predict reproductive factors and the risk of multiple heart and circulatory diseases.

The analysis showed that earlier first birth, a higher number of live births, and earlier first periods were associated with a higher risk of atrial fibrillation, coronary artery disease, heart failure, and stroke in women. However, it did not find an association between the age of menopause and heart and circulatory diseases.

Not the only risk factor

The group also found that much of the increased risk for earlier first periods resulted from this factor being associated with women having a higher body mass index (BMI). This means that lowering a person’s BMI could help to reduce this risk.

The Imperial researchers said that women shouldn’t worry about or avoid having children. Addressing risk factors like BMI, high cholesterol or high blood pressure can help to minimise the increased risk of heart and circulatory diseases brought on by an earlier first birth.

Further research is needed to understand the extent of the relationship between reproductive factors and cardiovascular disease risk.

‘Misconception is costing lives’

Dr Sonya Babu-Narayan, our Associate Medical Director, said: “The misconception that cardiovascular disease mostly affects men is costing women their health, and even their lives.

“It’s critical that women are empowered with the knowledge of what could put them at higher risk of developing heart disease or stroke in the future. This includes the well-known risks that affect everyone - but for women, there may be additional risk factors from their reproductive years to add to the list.

“If we’re going to save more women’s lives, asking about periods and pregnancy must be routine when assessing every woman’s risk of heart disease and stroke.”

Find out more about our risk factor research