Association between number of live births and markers of subclinical atherosclerosis: The Dallas Heart Study

Monika Sanghavi, Jacquelyn Kulinski, Colby R. Ayers, David B Nelson, Robert D Stewart, Nisha Parikh, James A de Lemos, Amit Khera

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Aims Higher parity has been associated with increased maternal risk of cardiovascular disease, but the mechanism is not well delineated. Whether the number of live births is associated with coronary and aortic subclinical atherosclerosis has not been fully evaluated. Methods and results Women from the Dallas Heart Study, a multiethnic population-based cohort of subjects aged 30-65 years, were included if they had data on self-reported live births and coronary artery calcium (CAC) measured by computed tomography or aortic wall thickness (AWT) by MRI. Coronary artery calcium was positive if >10 Agatston units, and aortic wall thickness if greater than the 75th percentile reference point for age and gender. Among the 1644 women included in the study, the mean age was 45 years and 55% were Black. Sequential multivariable models were done adjusting for age, race, traditional cardiovascular risk factors, body mass index, income, education, hormone replacement therapy, oral contraceptives, and physical activity. Using women with 2-3 live births as the reference, those with four or more live births had an increased prevalence of elevated coronary artery calcium (odds ratio (OR) 2.2, 95% confidence interval (CI) 1.28-3.65) and aortic wall thickness (OR 1.6, 95% CI 1.04-2.41). Women with 0-1 live births also had increased coronary artery calcium (OR 1.9, 95% CI 1.16-3.03) and aortic wall thickness (OR 1.5, 95% CI 1.05-2.09) after multivariable adjustment. Conclusion The number of live births is associated with subclinical coronary and aortic atherosclerosis, with an apparent U-shaped relationship. Further studies are needed to confirm this association and explore the biological underpinnings of these findings.

Original languageEnglish (US)
Pages (from-to)391-399
Number of pages9
JournalEuropean Journal of Preventive Cardiology
Volume23
Issue number4
DOIs
StatePublished - Mar 1 2016

Fingerprint

Live Birth
Atherosclerosis
Coronary Vessels
Odds Ratio
Confidence Intervals
Calcium
Hormone Replacement Therapy
Oral Contraceptives
Parity
Coronary Artery Disease
Body Mass Index
Cardiovascular Diseases
Tomography
Mothers
Exercise
Education
Population

Keywords

  • aortic wall thickness
  • cardiovascular disease
  • coronary artery calcification
  • pregnancy
  • subclinical atherosclerosis
  • Women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Epidemiology

Cite this

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title = "Association between number of live births and markers of subclinical atherosclerosis: The Dallas Heart Study",
abstract = "Aims Higher parity has been associated with increased maternal risk of cardiovascular disease, but the mechanism is not well delineated. Whether the number of live births is associated with coronary and aortic subclinical atherosclerosis has not been fully evaluated. Methods and results Women from the Dallas Heart Study, a multiethnic population-based cohort of subjects aged 30-65 years, were included if they had data on self-reported live births and coronary artery calcium (CAC) measured by computed tomography or aortic wall thickness (AWT) by MRI. Coronary artery calcium was positive if >10 Agatston units, and aortic wall thickness if greater than the 75th percentile reference point for age and gender. Among the 1644 women included in the study, the mean age was 45 years and 55{\%} were Black. Sequential multivariable models were done adjusting for age, race, traditional cardiovascular risk factors, body mass index, income, education, hormone replacement therapy, oral contraceptives, and physical activity. Using women with 2-3 live births as the reference, those with four or more live births had an increased prevalence of elevated coronary artery calcium (odds ratio (OR) 2.2, 95{\%} confidence interval (CI) 1.28-3.65) and aortic wall thickness (OR 1.6, 95{\%} CI 1.04-2.41). Women with 0-1 live births also had increased coronary artery calcium (OR 1.9, 95{\%} CI 1.16-3.03) and aortic wall thickness (OR 1.5, 95{\%} CI 1.05-2.09) after multivariable adjustment. Conclusion The number of live births is associated with subclinical coronary and aortic atherosclerosis, with an apparent U-shaped relationship. Further studies are needed to confirm this association and explore the biological underpinnings of these findings.",
keywords = "aortic wall thickness, cardiovascular disease, coronary artery calcification, pregnancy, subclinical atherosclerosis, Women",
author = "Monika Sanghavi and Jacquelyn Kulinski and Ayers, {Colby R.} and Nelson, {David B} and Stewart, {Robert D} and Nisha Parikh and {de Lemos}, {James A} and Amit Khera",
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T2 - The Dallas Heart Study

AU - Sanghavi, Monika

AU - Kulinski, Jacquelyn

AU - Ayers, Colby R.

AU - Nelson, David B

AU - Stewart, Robert D

AU - Parikh, Nisha

AU - de Lemos, James A

AU - Khera, Amit

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N2 - Aims Higher parity has been associated with increased maternal risk of cardiovascular disease, but the mechanism is not well delineated. Whether the number of live births is associated with coronary and aortic subclinical atherosclerosis has not been fully evaluated. Methods and results Women from the Dallas Heart Study, a multiethnic population-based cohort of subjects aged 30-65 years, were included if they had data on self-reported live births and coronary artery calcium (CAC) measured by computed tomography or aortic wall thickness (AWT) by MRI. Coronary artery calcium was positive if >10 Agatston units, and aortic wall thickness if greater than the 75th percentile reference point for age and gender. Among the 1644 women included in the study, the mean age was 45 years and 55% were Black. Sequential multivariable models were done adjusting for age, race, traditional cardiovascular risk factors, body mass index, income, education, hormone replacement therapy, oral contraceptives, and physical activity. Using women with 2-3 live births as the reference, those with four or more live births had an increased prevalence of elevated coronary artery calcium (odds ratio (OR) 2.2, 95% confidence interval (CI) 1.28-3.65) and aortic wall thickness (OR 1.6, 95% CI 1.04-2.41). Women with 0-1 live births also had increased coronary artery calcium (OR 1.9, 95% CI 1.16-3.03) and aortic wall thickness (OR 1.5, 95% CI 1.05-2.09) after multivariable adjustment. Conclusion The number of live births is associated with subclinical coronary and aortic atherosclerosis, with an apparent U-shaped relationship. Further studies are needed to confirm this association and explore the biological underpinnings of these findings.

AB - Aims Higher parity has been associated with increased maternal risk of cardiovascular disease, but the mechanism is not well delineated. Whether the number of live births is associated with coronary and aortic subclinical atherosclerosis has not been fully evaluated. Methods and results Women from the Dallas Heart Study, a multiethnic population-based cohort of subjects aged 30-65 years, were included if they had data on self-reported live births and coronary artery calcium (CAC) measured by computed tomography or aortic wall thickness (AWT) by MRI. Coronary artery calcium was positive if >10 Agatston units, and aortic wall thickness if greater than the 75th percentile reference point for age and gender. Among the 1644 women included in the study, the mean age was 45 years and 55% were Black. Sequential multivariable models were done adjusting for age, race, traditional cardiovascular risk factors, body mass index, income, education, hormone replacement therapy, oral contraceptives, and physical activity. Using women with 2-3 live births as the reference, those with four or more live births had an increased prevalence of elevated coronary artery calcium (odds ratio (OR) 2.2, 95% confidence interval (CI) 1.28-3.65) and aortic wall thickness (OR 1.6, 95% CI 1.04-2.41). Women with 0-1 live births also had increased coronary artery calcium (OR 1.9, 95% CI 1.16-3.03) and aortic wall thickness (OR 1.5, 95% CI 1.05-2.09) after multivariable adjustment. Conclusion The number of live births is associated with subclinical coronary and aortic atherosclerosis, with an apparent U-shaped relationship. Further studies are needed to confirm this association and explore the biological underpinnings of these findings.

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KW - coronary artery calcification

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