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Scientists Discover New Implications of Women’s Reproductive Health

A New Study Finds a Correlation Between Women's Reproductive Health and Cardiovascular Outcomes

January 13, 2021
Katie Sabel

Up until now, women’s reproductive health and women’s risk for cardiovascular outcomes have been thought to be independent. As such, there has been very little research on any potential correlation between women’s-health-related risk factors and cardiovascular disease or stroke. 

However, according to a new study from The BMJ, there is some positive correlation between female reproductive health and a higher risk of cardiovascular outcomes. 

The Study

Scientists conduct a study on women's health and cardiovascular issues using an umbrella review, pictured here by a person typing on a keyboard
In order to evaluate if there was a higher risk of cardiovascular disease for women with atypical reproductive health, UK researchers visited pre-existing databases. There, they evaluated systematic reviews and meta-analyses that had been conducted previously, and drew conclusions from those reports.

To conduct the study, a team of UK researchers conducted what is known as an “umbrella review.” In an umbrella review, researchers use the highest level of evidence from other reviews that are relevant to the research question at hand.

In this case, the UK researchers searched relevant, pre-existing research databases for systematic reviews and meta-analyses that investigated links between women’s reproductive health and risk of cardiovascular disease. Thirty two  total reviews were included in this evaluation, with average follow-up periods of 7-10 years within the reviews they consulted. 

Results

Scientists make conclusions about their data, represented here by a man writing on a notepad
After conducting their umbrella review, UK researchers found a number of different women’s health factors related to a higher risk of cardiovascular outcomes. However, there were also a number of women’s health factors that did not correlate to a higher risk, or even correlated to a lower risk of cardiovascular outcomes.

Through their study, researchers at BMJ pointed to several women’s health factors that were associated with a higher risk of cardiovascular outcomes. However, for as many health factors that were associated with a higher risk, there were more that were not associated with cardiovascular outcomes at all. 

Here is a breakdown of their findings.

Women’s Health Factors with a Positive Correlation

A photo of a sheet of oral contraceptives on a red background
Among the factors that were correlated with a higher risk of cardiovascular outcomes were the ingestion of combined oral contraceptives, pictured above.

In total, The BMJ found a total of ten women’s health factors that were correlated with a higher risk of cardiovascular problems:

  • Starting periods early (aka early menarche)
  • Use of combined oral contraceptives
  • Polycystic ovary syndrome
  • Miscarriage
  • Stillbirth
  • Preeclampsia
  • Diabetes during pregnancy
  • Preterm birth
  • Low birth weight
  • Early menopause

Besides pre-eclampsia, all of the factors on this list were correlated with up to a twofold risk of cardiovascular outcomes. Pre-eclampsia, however, was correlated even higher with a fourfold risk of heart failure.

Why were these factors correlated with a higher risk of cardiovascular outcomes? Possible explanations for these associations include a variety of other medical factors. A person’s family medical history, genetics, weight, and chemical imbalances from use of hormonal contraceptives all have to do with both their reproductive health and their cardiovascular health. Plus, a positive correlation between these health factors and higher risk of cardiovascular outcomes was also found in patients with high blood pressure and cholesterol levels.

Women’s Health Factors with No Correlation or Negative Correlation

A mother swaddles her baby
Some women’s health factors actually did not correlate with a higher risk of cardiovascular outcomes. In fact, breastfeeding even correlated with a reduced risk of cardiovascular disease.

While use of combined oral contraceptives correlated with a higher risk of cardiovascular outcomes, other birth controls and medicines did not. When it came to the use of progesterone-only contraceptives or non-oral hormonal contraceptive agents, neither was found to be associated with a higher risk of cardiovascular issues. Fertility treatment was likewise not found to have a negative cardiovascular association.

On the other hand, breastfeeding was actually found to be associated with a reduced risk of cardiovascular disease.

Study Limitations and Other Notes

A layout of medical equipment, including a blood pressure measuring device and a case of pills
Though the study is by no means perfect, we now have reason to believe that women’s reproductive health may be correlated with their cardiovascular risk. 

While this is the first indication of a correlation between women’s reproductive health and higher risk of cardiovascular issues, the researchers were quick to note that this study is by no means conclusive. For one, in their umbrella review, there was a non-negligible amount of missing data. 

What’s more, the study is further flawed due to the fact that the reports relied largely on observational evidence. No new study was conducted- the results that researchers found were based solely on data from previous studies. As such, unmeasured factors (also known as confounding factors) could have had an effect on the outcomes that the researchers observed. 

Even so, we do now have reason to believe that a woman’s reproductive health may not be completely independent of her risk for cardiovascular disease. The researchers behind this study hope that more research will be done into this subject in the future, and that reproductive risk factors become more widely incorporated into risk assessments for cardiovascular disease.

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