Age In Women Research Articles

Factors influencing the sexual drive of Russian women of reproductive age in the digital age

Aim. To assess the impact of age, number of sexual partners, having children, family income, and time spent with a smartphone or computer on the sexual drive of women of reproductive age in the era of information technology.
 Materials and methods. A study of the sexual drive of 79 women aged 18–35 in family (partner) relationships was conducted. The well-established international Female Sexual Function Index was used. Respondents also answered questions about some aspects of personality and social status. The results were evaluated using the methods of mathematical statistics: descriptive statistics, correlation, determination, and logit-regression analyses.
 Results. The intensity of sexual drive correlates with a woman's age, the number of sexual partners, and the family income. There was no correlation between the level of a woman's sexual drive and having children and the time women and their partners spend with computers and smartphones.

Evidence-informed recommendations on managing breast screening atypia: perspectives from an expert panel consensus meeting reviewing results from the Sloane atypia project.

Evidence-based clinical guidelines are essential to maximize patient benefit and to reduce clinical uncertainty and inconsistency in clinical practice. Gaps in the evidence base can be addressed by data acquired in routine practice. At present, there is no international consensus on management of women diagnosed with atypical lesions in breast screening programmes. Here, we describe how routine NHS breast screening data collected by the Sloane atypia project was used to inform a management pathway that maximizes early detection of cancer and minimizes over-investigation of lesions with uncertain malignant potential. A half-day consensus meeting with 11 clinical experts, 1 representative from Independent Cancer Patients' Voice, 6 representatives from NHS England (NHSE) including from Commissioning, and 2 researchers was held to facilitate discussions of findings from an analysis of the Sloane atypia project. Key considerations of the expert group in terms of the management of women with screen detected atypia were: (1) frequency and purpose of follow-up; (2) communication to patients; (3) generalizability of study results; and (4) workforce challenges. The group concurred that the new evidence does not support annual surveillance mammography for women with atypia, irrespective of type of lesion, or woman's age. Continued data collection is paramount to monitor and audit the change in recommendations.

Peripartum Cardiomyopathy: A Case Report

Background: Peripartum cardiomyopathy (PPCM) is a type of dilated cardiomyopathy of unknown origin. Predisposing factors for PPCM are multiparity, family history, ethnicity, smoking, diabetes, hypertension, preeclampsia, malnutrition, and advanced age in pregnant women or teenage pregnancy.
 Case presentation: A 29-year-old female patient was treated in the internal medicine department of Dr. M. Djamil General Hospital Padang on March 18th, 2023, with the main complaint of shortness of breath. On physical examination, signs of congestion were found. ECG shows sinus tachycardia, QT prolongation, and T inversion in V3-V6, II, III, and aVF. The patient is established with peripartum cardiomyopathy, community-acquired pneumonia, nonsevere low-risk MDR, hypochromic microcytic mild anemia et causa chronic disease, high-risk VTE, h hypokalemia et causa diuretic.
 Conclusion: Education regarding recurrent recurrence of PPCM in subsequent pregnancies is 30-50%. The prognosis depends on the recovery of left ventricular function; 30% of patients can return to baseline ventricular function within 6 months, and 50% of patients have an improvement in symptoms and ventricular function. Contraception is recommended that does not pose a risk of thromboembolism, such as a uterine device (IUD) and subcutaneous progesterone.

The relationship between depressive symptoms and physical performance in postmenopausal women: a cross-sectional investigation.

The relationship between depressive symptoms and declining physical performance in postmenopausal women has been extensively examined. However, various confounding factors can influence this association. This study aimed to investigate the link between depressive symptoms and physical performance in postmenopausal women while considering potential interfering factors. In this cross-sectional study, 137 postmenopausal women were categorized into two groups based on the presence of depressive symptoms (n = 58; mean ± SD age, 60.12 ± 8.45 y) and absence of depressive symptoms (n = 79; mean ± SD age, 60.72 ± 7.45) using the Geriatric Depression Scale (short version) (GDS-15). Thoracic kyphosis angle was measured using the flexicurve method. Physical performance was assessed through various tests, including Timed Up and Go, Five Times Stand and Sit Test, 6-minute Walking Speed, 10-meter Usual Walking Speed, 10-meter Fast Walking Speed, and dynamometry. The study compared variables between the two groups and used linear regression models adjusted for dynamometry, kyphosis angle, age, antidepressant usage, sitting time, and fall history to evaluate the relationship between GDS-15 scores and physical performance. Significant differences were observed in physical performance, body mass index, kyphosis angle, antidepressant usage, sitting time, and fall history between women with and without depressive symptoms. The GDS-15 showed a negative association with all walking speed tests (10-meter Usual Walking Speed, m/s; P < 0.001; B = -0.01; 10-meter Fast Walking Speed, m/s; P < 0.001; B = -0.02; 6-minute Walking Speed, m/s; P < 0.004; B = -0.01) and a positive association with the Five Times Stand and Sit Test ( P < 0.002; B = 0.21) and Timed Up and Go ( P < 0.001; B = 0.13) tests, regardless of grip strength, kyphosis angle, age, antidepressant use, sitting time, or fall history in postmenopausal women. This study underscores the independent and substantial impact of depressive symptoms on the physical performance of postmenopausal women. These findings emphasize the importance of addressing both mental health and physical well-being when providing care and support for this demographic.

Relationship between antihypertensive drug use and number of people with high blood pressure in FY 2018: a descriptive epidemiological study based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan open data

BackgroundIn most countries barring Japan, antihypertensive drug use has been reported using the defined daily doses/1000 inhabitants/day (DID). Although DID has been shown to allow for the assessment of the number of patients treated with a particular drug, the relationship between DID and the number of patients with hypertension has not been clarified. This study aimed to clarify the relationship between antihypertensive drug use and the number of people with high blood pressure based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) open data.MethodsDID was calculated by extracting the use of oral antihypertensive drugs from outpatient prescriptions in the NDB Open Data in FY 2018. The number of people with high blood pressure was calculated using the number of enrollees in each sex–age group for systolic and diastolic blood pressure in the 40–74 years age group. The correlation between the DID of antihypertensive drugs and the number of people with high blood pressure by sex and age class was evaluated using Spearman’s rank correlation coefficient.ResultsThe use of antihypertensive drugs increased with age in both men and women. Furthermore, in both sexes, dihydropyridine derivatives, calcium antagonists, and angiotensin II receptor blockers were the main drugs used from the age of 20 years onward. In addition, a very strong positive correlation was found between the number of people with high systolic blood pressure and DID in both sexes (men: r = 1, P < 0.05; women: r = 1, P < 0.05). In contrast, there was no significant correlation between the number of people with high diastolic blood pressure and DID in both sexes (men: r = − 0.214, P > 0.05; women: r = 0.393, P > 0.05).ConclusionsTo our knowledge, this study is the first to investigate the use of oral antihypertensive drugs in outpatient settings in Japan. In addition, the DID of antihypertensive drugs can be used as an alternative indicator of the number of people with high systolic blood pressure.

Burden of ischemic heart disease in the Middle East and North Africa (MENA) and attributable risk factors: An epidemiological analysis from 1990 to 2019

IntroductionDespite the burden of ischemic heart disease (IHD), there remains a paucity of research on the incidence, mortality, and burden of this condition in the Middle East and North Africa (MENA) regions. This study aimed to evaluate the epidemiology and the risk factors associated with IHD in the MENA region. MethodsThis study was performed based on the GBD study 2019 data. We retrieved the data related to the epidemiology and burden of IHD, including prevalence, incidence, years of life lost due to premature death (YLLs), years lived with disability (YLDs), and mortality at the global level and in MENA countries across years and sexes. ResultsIHD accounted for approximately 2.55 million (95 % UI 2.29–2.83) incident cases in MENA in 2019, with an age-standardized incidence rate of 613.87 (95 % UI 555.84–675.16) per 100 000 people, which has decreased by 9 % between 1990 and 2019. IHD accounted for 11.01 % of DALYs causes in MENA in 2019, an increase of 68 % compared to 1990. The DALYs rate from IHD increased with age in both men and women and was higher in men than in women in all age groups, except 85–89 years age-group, in 2019. ConclusionThe age-standardized prevalence and incidence of IHD are decreasing in MENA. However, this reduction is lower than the global level, which can be due to a weaker performance of the countries in the region in reducing the prevalence and incidence of the disease compared to the global average.

Imaging the brain to assess brain insulin action

AbstractBackgroundEver since the brain was identified as an insulin‐sensitive organ, it was quickly appreciated that insulin action in the brain affects cognitive and metabolic processes [1]. Epidemiological evidence suggests a strong link between reduced peripheral insulin sensitivity and age‐related neurodegenerative processes, including Alzheimer’s disease (AD) [2].MethodCharacterization of brain insulin resistance in humans is challenging and relies on different neuroimaging methods in combination with insulin stimulation techniques. In my talk, I will focus on the administration of intranasal insulin, which has been established over the last decades to disentangle peripheral from brain insulin effects [1]. In combination with functional neuroimaging, I will show recent data on the quantification of brain insulin sensitivity non‐invasively in humans of different age and weight groups [3].ResultWe could show that intranasal insulin can affect region‐specific activity and functional connectivity of the human brain. These diverse central insulin responses largely depend on its action in the hypothalamus, amygdala, hippocampus, striatum and parts of the insula and prefrontal cortex and influences a variety of metabolic and cognitive processes [3]. Specifically, I will show that disrupted brain insulin action can result in increased accumulation of visceral fat and altered reward learning in persons at high risk to develop T2D [4], but also in healthy individuals after overconsumption of high caloric foods (unpublished). Moreover, I will show that the effect of intranasal insulin in the hippocampus decreases with age in women but not men and that brain insulin responsivity is affected by the menstrual cycle (unpublished). Moreover, just recently, we could link enhanced brain insulin action in the mesocorticolimbic circuitry with improved cognitive and metabolic functions [5].ConclusionAs brain insulin acts on striatal dopamine function and hippocampal plasticity, enhancing brain insulin action could lead to new treatment options in diabetes and aging‐associated diseases.

Incidence and prevalence of myasthenia gravis in the United States: A claims-based analysis.

Myasthenia gravis (MG) is a rare neuromuscular disorder with geographically variable prevalence and incidence rates. A global trend of increasing prevalence of MG has been observed in the last few decades, and this study aimed to assess the current prevalence and incidence rates of MG in the United States. Data were extracted from the Clarivate Real-World Data Repository (2016-2021), a US claims and electronic health records database. The prevalence and incidence of MG were calculated for the year 2021 for males and females who were <2, 2-5, 6-11, 12-17, 18-49, 50-64, and ≥65 years of age, using population estimates from the US Census. The diagnosed prevalence and incidence of MG in the United States in 2021 were calculated to be 37.0 per 100,000 persons and 3.1 per 100,000 persons, respectively. While the incidence and prevalence of MG increased with age in both men and women, higher prevalence and incidence of MG were observed in younger women (<50 years) compared with men of matching age, and in older men (≥65 years) compared with women of the same age group. The updated prevalence and incidence of MG in the United States in 2021 are higher than previous reports from the 1980s and early 2000s, following a global trend of increased prevalence and incidence for this disorder in the last few decades.

The impact of gender‐specific survival on the incidence of dementia in Parkinson’s disease ‐ A cohort analysis of Parkinson’s disease patients in German health claims data for the years 2006 to 2017

AbstractBackgroundThe aim of our study is to analyze gender‐specific patterns of Parkinson’s disease dementia (PDD) incidence. In addition, we are investigating the extent to which gender differences in survival after initial Parkinson’s disease (PD) diagnosis influence differences in PDD risk among PD patients.MethodWe used a random sample of German longitudinal health claims data of persons at ages 65 years or older (2006‐2017). We identified incident PD cases who were followed‐up for a PDD diagnosis or death. We computed age‐ and gender‐specific PDD incidence rates, death rates, and cumulative PDD incidence functions with death as competing risk. In addition, we performed Cox regression models and Fine and Gray competing‐risk regression models, considering death as a competing event, to calculate PDD hazard ratios (HR), adjusted for important risk factors such as age at PD onset, PD severity in terms of modified Hoehn&amp;Yahr (HY) scale, comorbidities, and medications.ResultOf 2,195 incident PD cases, 602 people died and 750 people received a dementia diagnosis by the end of 2017. 44% of PD men and 45% of PD women had received a dementia diagnosis, 45% of PD men and 32% of PD women had died, and only 11% of PD men but 23% of PD women had survived without a PDD diagnosis. PDD risk among PD patients differs by gender when controlled for age at onset, severity of PD, comorbidities and medications, with men having a higher PDD risk than women (HR = 1.18, p = 0.029). When accounting for death, men and women do not differ regarding their PDD risk (HR = 1.02, p = 0.770). Gender‐specific analyses showed significant age and severity effects in women (Age: HR = 1.05, p&lt;0.001, HY 0‐2.5: reference, HY 3‐5: HR = 1.46, p = 0.011), but not in men.ConclusionWe found that older age at first PD diagnosis and higher disease severity increase PDD risk, but this association is attenuated for PD men when we consider death as a competing risk. This implies that the most frail PD men die rapidly before receiving a dementia diagnosis, whereas women with PD survive at higher rates than men, regardless of their age at onset and disease severity.

The effect of ascorbic acid on leukocyte reduction in burns injury patient: A short communication

Link of Video Abstract: https://youtu.be/-_-efYtOGxk Introduction: Challenges in managing burn injury include a high risk of sepsis and mortality. The study aimed to determine the effect of ascorbic acid on leukocyte reduction in burns injury patients. Methods: The design of this study was a case series reported using retrospectives. Data collection was carried out from January to December 2020. All participants were diagnosed with burn injuries. Participants received burn wound care with and without ascorbic acid or Vitamin C (Vit. C). Participants measured leukocyte levels on the first and fifth days. Result: The mean age of the participants was 32.08 ± 17.78 years, of which most of the participants were men (59.38%) with an average age of 35.21 ± 13.45 years, while the average age in women was 27.51 ± 22.52 years old. The mean TBSA of participants was 34.20 ± 21.21%, of which the mean TBSA for males was 39.45 ± 20.01% and for females 26.54 ± 21.32%. The mean participant leukocyte value on the first day was 21.49 ± 9.55 × 103/µL and on the fifth day, it was 11.26 ± 3.86 × 103/µL (z = -4.507; p &lt;0.001). There was a significant difference in the leukocyte participant values on days 1 and 5 of -10.23 ± 9.77 × 103/µL (t = -2.504; p = 0.018). Conclusion: Use of Vit. C in the management of burn injury has been shown to significantly reduce the number of leukocytes on the fifth day and reduce the risk of sepsis and mortality.

Correlation of immediate prevalence of cervical precancers and cancers with HPV genotype and age in women with atypical glandular cells cytology: A retrospective analysis of 369 cases.

This study aims to assess the immediate risk of cervical precancers and cancers in women with atypical glandular cells (AGC) cytology, based on high-risk human papillomavirus (hrHPV) genotypes and age. A retrospective analysis was conducted on 369 cases of AGC with immediate follow-up biopsy results, including 299 AGC-not otherwise specified (NOS) and 70 AGC-favor neoplastic (FN). Among the 369 AGC cases, 127 tested positive for hrHPV (34.4%). The predominant high-risk type was other 11 genotypes (44.1%), followed by 16+ (29.1%), 18/45+ (26.0%), and 16 and 18/45 double-positive (0.79%). Precancers and cancers were detected in 30.4% (112 of 369) and 9.8% (36 of 369) of cases, respectively. The HPV-18/45+ group had notably higher adenocarcinoma in situ and adenocarcinoma (AIS+) prevalence compared to other 11 genotype groups (p<.0001 and p=.001, respectively). The HPV-16+ group showed significantly higher high-grade cervical squamous epithelial lesion and squamous cell carcinoma prevalence than other 11 genotype groups (p<.0001 and p=.017, respectively). Using 40-year cutoff, older women had significantly higher prevalence of abnormal glandular lesion+lesions (17.6% vs. 7.6%, p=.005) and adenocarcinoma (AC) (12.4% vs. 2.5%, p=.001). Using 50-year cutoff, older women had higher prevalence of squamous cell carcinoma (SCC) (3.3% vs. 0.4%, p=.042) and AC (15.2% vs. 5.8%, p=.005). Subgroup analysis revealed that AGC-FN women showed more severe cervical pathology than AGC-NOS women (p<.001). AGC women have a significantly increased risk of cervical precancerous lesions and cancer. HPV genotyping and patient age factors need to be taken into consideration in the clinical management process of AGC patients.

Role of age, menopausal status, and symptoms in midlife women: Examination of sleep patterns and rest-activity circadian rhythms

BackgroundMidlife women experience menopausal transition at different ages with a variety of symptoms. This study aimed to identify the effects of age, menopausal status, and symptoms in women on their actigraphy-based sleep patterns and circadian rhythms. MethodsA total of 87 women aged 45–60 from the community and a gynecology clinic in Taiwan who had their sleep and circadian rhythms recorded with a 7-day actigraphy were analyzed. Multiple linear regression was used to estimate the association of age, menopausal status, and symptoms with sleep parameters and circadian rhythms. ResultsA sleep efficiency below 85 % was observed in 46.0 % of women, and those with severe somatic-vegetative or psychological symptoms tended to have problems with sleep latency (β = 0.22 and β = 0.42, respectively) and efficiency (β = −0.26 and β = −0.36, respectively). Women with more severe urogenital symptoms only experienced significantly longer sleep latency (β = 0.33). There was a weak correlation between circadian rhythms and symptoms. Additionally, perimenopausal (β = 0.30 and β = 0.35, respectively) and late postmenopausal (β = 0.67 and β = 0.59, respectively) women had higher relative amplitude and stability in circadian rhythms than premenopausal women. Age had no significant effect on sleep parameters or circadian rhythms. ConclusionsPremenopausal women had the most unstable day-to-day rhythms compared to their peri- and postmenopausal counterparts. Women with higher somatic-vegetative, psychological, and urogenital symptoms showed greater sleep problems. Psychological symptoms (e.g., depression, irritability, anxiety, exhaustion) were the strongest predictors for all sleep parameters. The mechanisms underlying these associations warrant investigation.

Evaluation of the Characteristics of Ovarian Endometriomas in Patients with Endometriosis: Efficacy of a Low-Dose Estrogen/Progestogen Combination

Objectives: Approximately 17–44% of women diagnosed with endometriosis have ovarian endometriomas (cysts). Although ovarian endometriomas may adversely affect quality of life and work performance, the associations among patient characteristics, cyst size, and pain in women with endometriosis have not yet been reported. Thus, the objective of this study was to assess the association among age, cyst size, and pain in women with ovarian endometriomas. Design: This was a retrospective secondary analysis of pooled data from six randomized clinical trials on the use of low-dose estrogen/progestogen drugs for endometriosis. Participants/Materials, Setting, and Methods: Data on 491 patients enrolled in four randomized and two nonrandomized trials between 2003 and 2017 were pooled. None of the participants had undergone surgical treatment before trial participation. We examined differences in dysmenorrhea score, menstrual pain score, analgesic score, and pelvic pain, as measured using a visual analog scale (VAS), by age and endometrioma size. Results: The mean dysmenorrhea, menstrual pain, and analgesic scores were 4.2, 2.2, and 2.0, respectively. The mean VAS for pelvic pain was 55, which decreased significantly with an increase in age. Age was not associated with endometrioma size, including volume and maximum diameter, or dysmenorrhea score. Additionally, endometrioma volume and maximum diameter were not associated with menstrual pain, analgesic score, or pelvic pain. Limitations: The details of past treatment history were not available; therefore, these could not be considered in the analysis. Additionally, the assessment of pain is heavily influenced by psychological factors, making it difficult to assess the true extent of pain. Conclusions: Endometrioma size was not associated with dysmenorrhea or pelvic pain measured using the VAS.

Glut4 expression in pro-atherogenic monocytes is associated with estrogen induced ROS formation

Abstract Background Glucose transporter (GLUT) 4 was shown to be expressed on monocytes with dynamic alterations. Moreover, increased formation of monocyte related reactive oxygen species (ROS) is an important marker for atherosclerosis and estrogen is known to increase ROS. However, the impact of estrogen on human monocytes have not been investigated. This is of great importance as a high number of aging women receive hormone replacement therapy (HRT) due to meno-pause symptoms. This was shown to be associated with high risk for ischemic events. In this study, we investigated the impact of estrogen on human monocytes about membrane expression of GLUT4 and ROS formation. Methods In this pilot study, we investigated human leukocytes from 88 healthy volunteers (54 female and 34 male) and 114 patients (56 female and 58 male) treated in the department of Cardiology, Pneumology and Vascular medicine, University Hospital Düsseldorf. Buffy coat was extracted out of whole blood by centrifugation and analysed by flow-cytometry. Amount of CD14+ and CD16+ monocytes was measured in % of all leukocytes in all participants. ROS and GLUT4 expression were assessed for monocyte type in dependence from increasing estrogen concentrations in a sub cohort by in-vitro incubation representing physiological peak and HRT concentrations (0, 500 and 2000 pM). Results Mean age of healthy volunteers was 31,2 years. Mean age of patients was 75,9 years. In patients, 51% were male, 58% had arterial hypertension, 33% diabetes mellitus type II, 16% were smokers and 19% were obese. Antiatherogenic monocytes (CD16+) were stable in males but decreased with age in females (female: r=-0.3130 p=0.0010; male: r=-0.1011 p=0.3946). In contrast, pro-atherogenic monocytes (CD14+) increased with age in females (female: r=0.4013 p=&amp;lt;0.0001; male: r=0.09135 p=0.4389). Increasing estrogen concentrations induced ROS formation in all monocytes in a dose dependent manner (0 – 947±124, 500 - 1312±258, 2000 - 1248±629 geometric mean, p=0.0327 [one-way ANOVA]). Separation in CD14+ and CD16+ monocytes revealed that this effect was only driven by increase in CD14+ monoctyes (0 - 1021±325, 500- 1160±239, 2000 – 513 geometric mean, p=0.0179), whereby CD16+ monocytes did not show relevant increase. GLUT4 membrane expression was inversely related to increasing estrogen levels with decrease in CD14+ (0 - 578±81, 500- 498±55, 2000- 507±41 geometric mean, p=0.0131) and numerical reduction in CD16+ monocytes by high estrogen levels (0- 592±77, 500 - 544±80, 2000- 537±72 geometric mean, p=0.0784) Conclusion In this study, we could show that high estrogen levels induce decrease of GLUT4 membrane expression in human monocytes. This might be associated with increased ROS formation in pro-atherogenic CD14+ monocytes which are already increased with age in women. This might reflect a relevant mechanism for the increased rate of ischemic events by HRT.

Evaluation of a proactive cardiovascular risk screening program after preeclampsia: the Queen of Hearts study

Abstract Introduction: Despite the long-term risk for cardiovascular disease (CVD) after preeclampsia (PE), guidelines do not include specific recommendations on how to apply structural cardiovascular (CV) screening after complicated pregnancy. Insight in the prevalence of conventional CV risk factors at different age intervals may provide insight in the necessity of timely CV screening. Purpose Evaluate the prevalence of conventional CV risk factors in former pregnant women at different age intervals. Methods Data was used from the cross-sectional Queen of Hearts study, which includes relatively young women with a history of PE and a control group of women with a history of uncomplicated pregnancy. Based on history taking we established the prevalence of known diagnoses of hypertension, diabetes mellitus (DM) and hypercholesterolemia. Besides, a CV risk assessment was performed, including 30-minutes blood pressure (BP) measurement and venous blood sampling. De novo diagnosis of hypertension, DM and hypercholesterolemia were defined as systolic BP ≥140mmHg and/or diastolic BP ≥90mmHg, fasting glucose ≥7mmol/L, and Low Density Lipoprotein (LDL) &amp;gt;3.4mmol/L, respectively. Odds Ratio’s (ORs) with corresponding 95% confidence intervals (CI) were established, and survival analysis using Kaplan Meier curves and cox regression was performed. Results We included 1040 (39 ± 8 years) women who had suffered PE and 518 who experienced normotensive pregnancy (44 ± 8 years). In both groups, the prevalence of hypertension and hypercholesterolemia increased statistically significantly with advancing age (p-values trend &amp;lt;0.001), but this age-related increase seemed larger in former preeclamptic women. Across all age groups, former preeclamptic women suffered more often hypertension than controls whilst differences seemed most pronounced for younger individuals (&amp;lt;40 years: 12.4% vs. 2.1% respectively, OR 6.6 (95% CI 2.1-18.3); 40-49 years: 24.8% vs. 6.9% respectively, OR 4.5 (95% CI 2.4-8.3); ≥50 years: 38.2% vs. 15.7% respectively, OR 3.3 (95% CI 1.8-6.1)). A proportion of 33.5% former preeclamptic women and 23.9% controls suffered at least one CV risk factor (OR 1.6, 95% CI 1.3-2.0). This prevalence significantly increased with age, being 25.0% among former preeclamptic women aged &amp;lt;40 years and increasing up to 65.7% if aged ≥50 years. The age of CV risk diagnosis was on average 8 years younger in former preeclamptic women than controls, supported by survival analyses ((log rank p-value &amp;lt;0.001, Hazard Ratio 2.6 (95% CI 2.1-3.2)). Conclusions The prevalence of hypertension, DM and hypercholesterolemia is significantly higher in women with former PE compared to controls, already below the age of 40 and increasing with age. The age-related increase in risk was larger among former preeclamptic women than controls. Awareness on the high prevalence of CV risk factors at young age in former preeclamptic women should be taken into account when developing screening guidelines.Prevalence of CV risk factorsKaplan Meier curve CV risk factors

Abstract 16954: Sex Differences in Cardiac and Vascular Function With Healthy Aging: Implications for Greater Risk of HFpEF in Women

Introduction: Mechanisms mediating the disproportionate risk for heart failure with preserved ejection fraction (HFpEF) in women are poorly understood. Impaired stroke volume (SV) reserve, increased afterload, arterial and left ventricular (LV) stiffness contribute to exercise intolerance in HFpEF. It is unknown whether subclinical changes in these measures predispose women to HFpEF; therefore, we compared resting and exercise cardiovascular structure and function across age in healthy men and women. Methods: We studied 192 sedentary normotensive, non-obese adults (53% female; age: 58 ± 13 [20-90] years) at rest, during sub- and maximal exercise. We measured systolic blood pressure (SBP; electrosphygmomanometry) and aortic stiffness (carotid-femoral pulse wave velocity; aPWV). Myocardial stiffness was assessed as the slope of individual pressure-volume (right heart catheterization-echocardiography) curves generated by graded LV loading and unloading. SV was calculated from cardiac output (Q˙c; C 2 H 2 rebreathe)/heart rate to assess afterload (Ea; SBP/SV) and SV reserve (% change from rest) during exercise. Data were compared via two-way ANOVA (age*sex). Results: There was no significant age*sex interaction for aPWV, SV reserve, resting or maximal SBP, or myocardial stiffness; however, there was a main effect for sex with higher myocardial stiffness in women (Figure). aPWV and SV reserve were not different between sexes (p=0.349, p=0.940). Maximal exercise SBP was lower in women, but a similar proportion of each sex had an exaggerated maximal exercise SBP (Men: &gt;210; Women: &gt;190 mmHg; 28% vs 35%, χ 2 =0.290). Peak exercise afterload was higher in women (Figure) due to lower SV. Conclusions: Increased risk for HFpEF in women may be driven in part by greater myocardial stiffness throughout the aging process. Sex related abnormalities in afterload were most prominent with exercise in women, which may predispose to LV hypertrophy and increased stiffness.

Abstract 13041: Effects of Parity on Arterial Stiffness Persists Into Old Age, Independent of Chronological Ageing

Introduction: Persistent effects of reproductive factors on vascular ageing, over chronological ageing, as examined through objective measurements of arterial stiffness, are rarely studied. Hypothesis: We hypothesized that the effects of parity and maternal age at first birth (AFB) on vascular ageing will persist over time independent of chronological ageing, in older Asian women. Methods: Among a community-based cohort of older Asian adults without cardiovascular disease, we prospectively studied demographics, parity, AFB, and cardiovascular risk factors, at baseline and 5-year examination timepoints. Arterial stiffness was measured through pulse wave velocity (PWV) using a cuff-based auscultatoric oscillometric pulse wave analysis machine. Results: 170 women (baseline mean age 60.76±13.75 years) were included. Parity ranged from 0 to 8 (mean parity 2±1.3). AFB ranged from 18 to 44 (mean age 28±4.4) years. By regression, univariate determinants of 5-year PWV were parity (β=0.491, p=&lt;.001), αFB (β=-0.107, p=.011), baseline age (β=3.884, p=&lt;.001), body mass index (βμΙ) (β=0.147, p=.006), waist circumference (β=0.076, p=&lt;.001), diabetes (β=1.681, p=&lt;.004), hypertension (β=2.383, p=&lt;.001), dyslipidemia (β=2.220, p=&lt;.001), 5-year age (β=3.886, p=&lt;.001),waist circumference (β=0.085, p=&lt;.001), diabetes (β=1.723, p=.001), hypertension (β=2.485, p=&lt;.001). Based on multivariate regression, parity (β=0.345, 95% CI 0.105, 0.586, p=.005), but not AFB, was independently associated with 5-year PWV, independent of age. Conclusions: Parity and AFB correlated with PWV, a marker of arterial stiffness, in old age in Asian women. Accounting for chronological ageing and clinical factors across 5 years, parity exerted a persistent independent effect on arterial stiffness in older women. Other biological factors surrounding parity in these women apart from traditional cardiovascular risk factors may explain these observations.

Menopausal age and cardiovascular disease risk in American women: evidence from the National Health and Nutrition Examination Survey

Objective Cardiovascular disease (CVD) is a significant contributor to the deaths of females, and premature menopause adds to the risk of CVD in females. Therefore, our study aimed to investigate the age of menopause and CVD incidence in American females using data from the National Health and Nutrition Examination Survey (NHANES). Method We analyzed data from 6347 females to investigate the association between menopausal age and the risk of CVD using multivariate logistic regression analysis. Results The study found that a later menopausal age reduces the risk of developing CVD (odds ratio [OR] = 0.74, 95% confidence interval [CI] = 0.63 − 0.88, p < 0.001). Moreover, females with early-onset CVD had an increased risk of premature menopause before the age of 40 years (OR = 2.44, 95% CI = 1.60 − 3.72, p < 0.001). Conclusion Menopausal age is associated with the risk of developing CVD in American females. Specifically, if menopause occurs earlier, there is an increased risk of CVD. Additionally, early-onset CVD significantly raises the risk of premature menopause, which in turn has important implications for female reproductive health.

Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria.

Invasive cervical cancer (ICC) is an HIV-associated cancer that is preventable and precancerous stages including early ICC stages could be detected through screening offering opportunities for treatment and cure. The high incidence in women living with HIV and late presentation often at advanced stages of ICC with limited treatment facilities often result in early mortality. We sought to compare the epidemiologic characteristics and survival differences in HIV status of ICC patients in Nigeria. We conducted a cohort study at two federal academic hospital-based research sites in Jos University Teaching Hospital, and Lagos University Teaching Hospital Nigeria, between March 2018 and September 2022. We enrolled women with histologically confirmed ICC with known HIV status, and FIGO staging as part of the United States of America's National Institutes of Health/National Cancer Institute funded project titled 'Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria'. The primary outcome was all-cause mortality with assessment of overall survival (OS) and time to death after ICC diagnosis. OS distribution was estimated using the method of Kaplan-Meier and compared between groups using the log-rank test. A total of 239 women with confirmed ICC were enrolled and included in this analysis, of whom 192 (80.3%) were HIV-negative (HIV-/ICC +), and 47 (19.7%) were HIV-positive (HIV +/ICC +). The HIV +/ICC + patients were younger with median age 46 (IQR: 40-51) years compared to 57 (IQR: 45-66) among HIV-/ICC + (P < 0.001). Squamous cell carcinoma was the commonest histopathologic variant in 80.4% of ICC diagnosis, moderately differentiated tumor grade in 68.1% in both groups. HIV +/ICC + diagnosis was at FIGO advanced stages in 64.9% compared to 47.9% in HIV-/ICC +. The HIV-/ICC + women had better OS compared to HIV +/ICC + participants (p = 0.018), with 12-month OS 84.1% (95%CI 75-90%) and 67.6% (95%CI 42-84%) respectively. ICC is diagnosed at a relatively young age in women living with HIV, with a significantly lower overall survival probability compared to women without HIV. The trend of presentation and diagnosis at advanced stages in women living with HIV could partly explain the differences in overall survival.

Association of Triglyceride-Glucose Index with Risk of Large for Gestational Age: A Prospective Cohort Study.

To evaluate the association of the baseline triglyceride-glucose (TyG) index in the first trimester of pregnancy with the risk of large for gestational age (LGA) in Southeast Chinese pregnant women. A prospective birth cohort study recruiting 12,108 pregnant women at their first prenatal visit before 13 gestation weeks was conducted in 2019-2022. Baseline characteristics were collected from medical records or using questionnaires and blood samples were collected in the first trimester. The TyG index was obtained through the formula: ln[triglyceride (mg/dl)×fasting plasma glucose (mg/dl)/2]. The binary logistic regression model was performed to calculate the odds ratio (OR) and 95% confidence intervals (CI) to reveal the relationship between TyG index and LGA. Receiver-operating characteristic curve analysis was conducted to evaluate the ability of the TyG index to predict the risks of LGA. The overall incidence of LGA in the current study was 11.4% and the incidence of LGA increased with the baseline TyG index increasing. The risk of LGA was 2.05 (1.64, 2.57) for per unit increase in baseline TyG index. The increasing trend was found across the TyG index quartiles and the highest TyG quartiles raised the risk of LGA to 1.86 (95% CI: 1.51, 2.27) compared to the bottom TyG quartiles after full adjustment. The risk of LGA remained positive after stratification analysis. The AUC was 0.584 (95% CI: 0.569~0.600) in the entire subject, and the threshold was 8.34, with a sensitivity of 0.74 and specificity of 0.38. The findings suggested that a higher TyG index in the first trimester was independently associated with higher risk of LGA and high TyG index in the first trimester may play as a early predictor for LGA.