Heart failure & cardiomyopathies
Reproductive history, hormonal exposure, and risk of heart failure in postmenopausal women: a Korean nationwide study
Authors' conclusion
Prolonged lifetime exposure to both endogenous and exogenous female sex hormones is associated with lower HF incidence and subsequent mortality.
Study context
- Population
- Postmenopausal women without prior heart failure (HF) or structural heart disease, with intact ovaries and uterus, Korea
- Participants
- 3,692,157 women48,640 HF hospitalizations
- Exposure
- Reproductive factors and hormone use and HF risk
- Outcome
- HF hospitalization
- Follow-up
- Median 120 months
Methodological detailsnationwide, Korean National Health Insurance Service database, Fine-Gray competing risk models
- Nationwide
- Korean National Health Insurance Service database
- Fine-Gray competing risk models
Main finding
As reported in the abstract
HF risk
Subdistribution hazard ratio (99.3% CI)P value
OC ≥1yvs OC non-user
0.942(0.896–0.990)
MHT ≥5yvs MHT non-user
0.782(0.708–0.863)
Menarche age ≥17vs Menarche 13-16y
1.099(1.071–1.128)
P < 0.001for trendMenopause age 40-44yvs Menopause 50-54y
1.229(1.173–1.288)
P < 0.001for trendReproductive period <30yvs Reproductive period ≥40y
1.284(1.213–1.361)
P < 0.001for trendObservational data: associations, not effects.
Further findings
Mortality among women with HF
- Oral contraceptive (OC) and menopausal hormone therapy (MHT) use associated with lower mortality; earlier menarche, earlier menopause and shorter reproductive period linked to increased mortality
- Multivariable Cox regression
Original publication
Reproductive history, hormonal exposure, and risk of heart failure in postmenopausal women: a Korean nationwide study. Eur Heart J. Published 25 May 2026. doi:10.
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