Abstract

Objective: Early Vascular Ageing (EVA) is a function of biological ageing and a determinant of cardiovascular health. Arterial stiffness (AS), as the core component of EVA, is best measured by carotid femoral pulse wave velocity (c-f PWV). Previous studies find AS to be associated with numerous cardiovascular risk factors, but the role of the reproductive history of women has so far not been examined in direct relation to AS. We aimed to investigate the association between AS and reproductive history in middle-aged women from an urban population. Design and method: Descriptive data were used from the Malmö Diet Cancer Study (MDCS), a large prospective study based on individuals born between 1923 and 1945, and who lived in Malmö, Sweden. Social and reproductive data were retrieved from a questionnaire from the baseline examinations in 1991–1994. Medical history and c-f PWV measurements (acquired by SphygmoCor®) were obtained the follow-up examination in 2007–2012. In total, 1775 women were included in the study, out of which 1270 had a complete data sets. Multiple linear regression was used to calculate the association between c-f PWV and reproductive variables, adjusting for age, BMI, and hemodynamic factors. A Reproductive Risk Index (RRI) was created to capture the combined effect of separate reproductive variables (age at menarche, parity, and age at menopause). Results: Age at menarche (beta = −0.040, p < 0.05) was inversely associated with logarithmic c-f PWV when controlling for confounders. Parity, age at menopause, number of reproductive years and RRI were not significantly associated with the natural logarithm of c-f PWV. However, RRI was significantly associated (beta = 0.050, p < 0.05) with non-logarithm (supposedly non-linear) c-f PWV. Conclusions: Data show that an early age at menarche is significantly associated with an increase in logarithmic c-f PWV in mid-life. The association may be mediated through an early onset of exposure to a different hormonal environment. Therefore, a history of early menarche may help to identify women at risk for EVA, although it is not clear whether age at menarche mediates a direct effect or is only a risk marker of other factors influencing arterial stiffness.

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