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Reproductive Factors and the Risk of Incident Peripheral Arterial Disease Hospitalisation or Death: A Cohort Study of UK Biobank Participants
32 Pages Posted: 9 Apr 2025
More...Abstract
Background: Associations between reproductive factors and risk of peripheral arterial disease (PAD) are not well established. This study examined reproductive factors and hormone use in relation to incident PAD risk in women.
Methods: UK Biobank cohort study. Cox proportional hazard regressions were used to estimate adjusted hazard ratios (adjHRs) for reproductive factors with incident PAD, adjusting for multiple confounders.
Findings: Over a median follow-up of 13·2 years 2,942/272,557 women and 5,432/227,403 men developed PAD. Early and late menarche (age <12 and >14 years) was associated with increased PAD risk (adj HR 1·43 95% CI[1·32, 1·55], p<·001, 1·36 [1·23, 1·49], p<·001, respectively). Reduction in PAD risk was observed for an older age at first birth (adjHR 0·95 [0·94, 0·96], p<·001, per year). While, cumulative increased PAD risk was observed per miscarriage (adjHR 1·06 [1·01, 1·11] p=·027), per stillbirth (adjHR 1·18 [1·03, 1·36] p=·014) and per abortion (adjHR 1·09 [1·01, 1·18], p=·028). A longer duration of reproductive years, later natural menopause, and use of oral contraceptives (adjHR 0·85 [0·78, 0·93], p<·001) were associated with reduced PAD risk. Hysterectomy or oophorectomy were associated with increased PAD risk (adjHR 1·24 [1·13, 1·35], p<·001, 1·24 [1·10, 1·39], p<·001, respectively). Associations between the number of children and PAD were U-shaped and similar for both sexes, with a multiple-adjusted HR of 1·13 ([1·00, 1·25], p=·041) for women and 1·25 ([1·16, 1·34], p<·001) for men, with 4 or more children.
Interpretation: Reproductive factors are associated with increased risk of PAD and should be considered in future risk stratification.
Keywords: peripheral arterial disease, sex, sex-specific risk factors
Suggested Citation: Suggested Citation