TY - JOUR T1 - Heartbeat: cardiovascular disease risk and reproductive factors in women JF - Heart JO - Heart SP - 1045 LP - 1047 DO - 10.1136/heartjnl-2018-313503 VL - 104 IS - 13 AU - Catherine M Otto Y1 - 2018/07/01 UR - http://heart.bmj.com/content/104/13/1045.abstract N2 - The likelihood of cardiovascular disease (CVD) in both women and men largely is explained by well-known lifestyle and clinical risk factors. Several studies have suggested that a woman’s reproductive history also might affect the risk of CVD, but results have been inconsistent and methodology suboptimal. In this issue of Heart, Peters and Woodward1 report the association between several reproductive factors and subsequent incident CVD over 7 years of follow-up in 482,000 participants in the UK Biobank study with CVD defined as incident myocardial infarction (fatal or non-fatal) or stroke.1 The risk of CVD was increased in women with early menarche (<12 years), early menopause (<47 years), younger age at first birth, or a history of miscarriage, stillbirth or hysterectomy (figure 1). Interestingly, in both men and women, each additional child was associated with an increased risk of CVD with an HR of 1.03 (1.00 to 1.06) in women and 1.03 (1.02 to 1.05) in men.Figure 1 Penalised spline plots with adjusted HRs (95% CI) for cardiovascular disease associated with women’s age at menarche and age at natural menopause. Analyses are adjusted for age, Townsend deprivation index, smoking status, systolic blood pressure, history of diabetes and body mass index.Unfortunately, the question of whether any of these associations are causal … ER -