Women who experience infertility may face higher heart failure risk

Infertility, which affects one in five U.S. women, was found to be associated with a 16% increase in heart failure risk in a new study published by the Journal of the American College of Cardiology.[1]

To make the determination, researchers from Massachusetts General Hospital (MGH) partnered with the Women’s Health Initiative (WHI) to study the health outcomes of 38,528 postmenopausal women—14% of whom had a history of infertility—over a 15-year period. 

We are beginning to recognize that a woman's reproductive history tells a lot about her future risk of heart disease,” said first author Emily Lau, MD, MPH, cardiologist and director of the Menopause, Hormones & Cardiovascular Clinic at MGH in a statement about the study results

The study also examined specific associations between infertility history and each of the two heart failure subtypes: heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). The former—in which the heart muscle does not relax well, but continues to pump a normal volume of blood during each beat—is more common in women. It also showed even higher associations with infertility; a woman with a history of infertility was associated with a 27% higher risk of HFpEF. 

 

“I think our findings are particularly noteworthy because heart failure with preserved ejection fraction is more prevalent in women,” Lau said. “We don't understand why we see HFpEF more in women. Looking back in a woman's early reproductive life may give us some clues as to why."

The association between infertility and heart failure was independent of other cardiovascular risk factors and and infertility-related risk factors such as thyroid disease, irregular menses and early menopause. 

The researchers noted that knowing about this connection can help doctors advise patients with a history of infertility about their increased risks, potentially pushing these high-risk patients to take steps to address modifiable risk factors such as high cholesterol or smoking. 

Related Heart Failure Content:

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Reference:

1. Emily S. Lau, Dongyu Wang, Mary Roberts, et al. Infertility and Risk of Heart Failure in the Women’s Health Initiative. J Am Coll Cardiol. 2022 Apr, 79 (16) 1594–1603.

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