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- Title
Sex Hormones and Incident Heart Failure in Men and Postmenopausal Women: The Atherosclerosis Risk in Communities Study.
- Authors
Di Zhao; Guallar, Eliseo; Ballantyne, Christie M.; Post, Wendy S.; Ouyang, Pamela; Vaidya, Dhananjay; Xiaoming Jia; Ying, Wendy; Subramanya, Vinita; Ndumele, Chiadi E.; Hoogeveen, Ron C.; Michos, Erin D.; Zhao, Di; Jia, Xiaoming
- Abstract
<bold>Context: </bold>Sex differences exist in heart failure (HF) phenotypes, but there is limited research on the role of sex hormones in HF and its subtypes.<bold>Objective: </bold>To examine the associations of total testosterone, dehydroepiandrosterone sulfate (DHEA-S), and sex hormone-binding globulin (SHBG) with incident HF, HF with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF).<bold>Design: </bold>Atherosclerosis Risk in Communities (ARIC) study (prospective cohort study). Median follow-up is 19.2 years.<bold>Setting: </bold>General community.<bold>Participants: </bold>4107 men and 4839 postmenopausal women, with mean age of 63.2 (standard deviation [SD] 5.7) and 62.8 (5.5) years, respectively.<bold>Exposure: </bold>Plasma sex hormone levels were measured at visit 4 (1996-1998).<bold>Main Outcome Measures: </bold>Incident HF events were identified through hospital discharge codes and death certificates.<bold>Results: </bold>The Hazard Ratios for HF associated with 1 SD decrease in log-transformed total testosterone, DHEA-S, and SHBG were 1.10 (95% confidence interval 1.03, 1.17), 1.07 (1.00, 1.15), and 1.04 (0.96, 1.11) in men, and 1.05 (0.99, 1.13), 1.17 (1.09, 1.24), and 0.93 (0.85, 1.01) in women, respectively. The associations between sex hormones with subtypes of HF had similar patterns but were attenuated and became statistically insignificant.<bold>Conclusion: </bold>In this prospective cohort, lower levels of endogenous testosterone and DHEA-S in men and DHEA-S in postmenopausal women were associated with the development of HF. Similar directions of association in both sexes and both HF subtypes suggest that sex hormones play a role in the development of HF through common pathways regardless of sex.
- Subjects
SEX hormones; POSTMENOPAUSE; HEART failure; DIASTOLE (Cardiac cycle); CLIMACTERIC; LIQUID chromatography-mass spectrometry; ATHEROSCLEROSIS complications; GLYCOPROTEIN analysis; RESEARCH; TESTOSTERONE; RESEARCH methodology; DEHYDROEPIANDROSTERONE; EVALUATION research; MEDICAL cooperation; ATHEROSCLEROSIS; SEX distribution; COMPARATIVE studies; RESEARCH funding; STROKE volume (Cardiac output); LONGITUDINAL method
- Publication
Journal of Clinical Endocrinology & Metabolism, 2020, Vol 105, Issue 10, p1
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgaa500