Show simple item record

dc.contributor.authorParikh, Nisha I.
dc.contributor.authorKapphahn, Kristopher
dc.contributor.authorHedlin, Haley
dc.contributor.authorOlgin, Jeffrey E.
dc.contributor.authorAllison, Matthew A.
dc.contributor.authorMagnani, Jared W.
dc.contributor.authorRyckman, Kelli R.
dc.contributor.authorWaring, Molly E.
dc.contributor.authorPerez, Marco Valentin
dc.contributor.authorHoward, Barbara V.
dc.date2022-08-11T08:09:51.000
dc.date.accessioned2022-08-23T16:45:54Z
dc.date.available2022-08-23T16:45:54Z
dc.date.issued2018-08-17
dc.date.submitted2018-10-15
dc.identifier.citation<p>BMJ Open. 2018 Aug 17;8(8):e019129. doi: 10.1136/bmjopen-2017-019129. <a href="https://doi.org/10.1136/bmjopen-2017-019129">Link to article on publisher's site</a></p>
dc.identifier.issn2044-6055 (Linking)
dc.identifier.doi10.1136/bmjopen-2017-019129
dc.identifier.pmid30121588
dc.identifier.urihttp://hdl.handle.net/20.500.14038/40775
dc.description.abstractOBJECTIVES: Pregnancy, menses and menopause are related to fluctuations in endogenous sex hormones in women, which cumulatively may alter cardiac electrical conduction. Therefore, we sought to study the association between number of pregnancies and reproductive period duration (RD, time from menarche to menopause) with ECG intervals in the Women's Health Initiative Clinical Trials. DESIGN: Secondary analysis of multicentre clinical trial. SETTING: USA. PRIMARY OUTCOME MEASURES: ECGintervals: PR interval, P-wave duration, P-wave dispersion, QTc interval. PARTICIPANTS: n=40 687 women (mean age=62 years) participating in the Women's Health Initiative Clinical Trials. 82.5% were white, 9.3% black, 4% Hispanic and 2.7% Asian. METHODS: In primary analysis, we employed multivariable linear regression models relating number of pregnancies and RD with millisecond changes in intervals from enrolment ECG. We studied effect modification by hormone therapy use. RESULTS: Among participants, 5+ live births versus 0 prior pregnancies was associated with a 1.32 ms increase in PR interval (95% CI 0.25 to 2.38), with a graded association with longer QTc interval (ms) (none (prior pregnancy, no live births)=0.66 (-0.56 to 1.88), 1=0.15 (-0.71 to 1.02), 2-4=0.25 (-0.43 to 0.94) and 5+ live births=1.15 (0.33 to 1.98), p=0.008). RD was associated with longer PR interval and maximum P-wave duration (but not P-wave dispersion) among never users of hormone therapy: (PR (ms) per additional RD year: 0.10 (0.04 to 0.16); higher P-wave duration (ms): 0.09 (0.06 to 0.12)). For every year increase in reproductive period, QTc decreased by 0.04 ms (-0.07 to -0.01). CONCLUSIONS: An increasing number of live births is related to increased and RD to decreased ventricular repolarisation time. Both grand multiparity and longer RD are related to increased atrial conduction time. Reproductive factors that alter midlife cardiac electrical conduction system remodelling in women may modestly influence cardiovascular disease risk in later life. TRIAL REGISTRATION NUMBER: NCT00000611.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=30121588&dopt=Abstract">Link to Article in PubMed</a></p>
dc.rights© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectECG
dc.subjectadult cardiology
dc.subjectmenopause
dc.subjectpregnancy
dc.subjectwomen
dc.subjectUMCCTS funding
dc.subjectCardiovascular Diseases
dc.subjectCardiovascular System
dc.subjectFemale Urogenital Diseases and Pregnancy Complications
dc.subjectReproductive and Urinary Physiology
dc.subjectWomen's Health
dc.titleEffects of reproductive period duration and number of pregnancies on midlife ECG indices: a secondary analysis from the Women's Health Initiative Clinical Trial
dc.typeJournal Article
dc.source.journaltitleBMJ open
dc.source.volume8
dc.source.issue8
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=4597&amp;context=oapubs&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/oapubs/3585
dc.identifier.contextkey13079062
refterms.dateFOA2022-08-23T16:45:55Z
html.description.abstract<p>OBJECTIVES: Pregnancy, menses and menopause are related to fluctuations in endogenous sex hormones in women, which cumulatively may alter cardiac electrical conduction. Therefore, we sought to study the association between number of pregnancies and reproductive period duration (RD, time from menarche to menopause) with ECG intervals in the Women's Health Initiative Clinical Trials.</p> <p>DESIGN: Secondary analysis of multicentre clinical trial.</p> <p>SETTING: USA.</p> <p>PRIMARY OUTCOME MEASURES: ECGintervals: PR interval, P-wave duration, P-wave dispersion, QTc interval.</p> <p>PARTICIPANTS: n=40 687 women (mean age=62 years) participating in the Women's Health Initiative Clinical Trials. 82.5% were white, 9.3% black, 4% Hispanic and 2.7% Asian.</p> <p>METHODS: In primary analysis, we employed multivariable linear regression models relating number of pregnancies and RD with millisecond changes in intervals from enrolment ECG. We studied effect modification by hormone therapy use.</p> <p>RESULTS: Among participants, 5+ live births versus 0 prior pregnancies was associated with a 1.32 ms increase in PR interval (95% CI 0.25 to 2.38), with a graded association with longer QTc interval (ms) (none (prior pregnancy, no live births)=0.66 (-0.56 to 1.88), 1=0.15 (-0.71 to 1.02), 2-4=0.25 (-0.43 to 0.94) and 5+ live births=1.15 (0.33 to 1.98), p=0.008). RD was associated with longer PR interval and maximum P-wave duration (but not P-wave dispersion) among never users of hormone therapy: (PR (ms) per additional RD year: 0.10 (0.04 to 0.16); higher P-wave duration (ms): 0.09 (0.06 to 0.12)). For every year increase in reproductive period, QTc decreased by 0.04 ms (-0.07 to -0.01).</p> <p>CONCLUSIONS: An increasing number of live births is related to increased and RD to decreased ventricular repolarisation time. Both grand multiparity and longer RD are related to increased atrial conduction time. Reproductive factors that alter midlife cardiac electrical conduction system remodelling in women may modestly influence cardiovascular disease risk in later life.</p> <p>TRIAL REGISTRATION NUMBER: NCT00000611.</p>
dc.identifier.submissionpathoapubs/3585
dc.contributor.departmentDivision of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences
dc.source.pagese019129


Files in this item

Thumbnail
Name:
e019129.full.pdf
Size:
313.2Kb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Except where otherwise noted, this item's license is described as © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.