Menopausal symptoms and risk of heart failure: a retrospective analysis from Taiwan National Health Insurance Database

• Published in: ESC Heart Failure 2021-08, Vol.8 (4), p.3295-3307
• Main Authors: Huang, Ching‐Hui, Kor, Chew‐Teng, Lian, Ie‐Bin, Chang, Chia‐Chu
• Format: Article
• Language: English
• Subjects: Age; Aging; Breast cancer; Cardiovascular disease; Chronic illnesses; Codes; Comorbidity; Diabetes; Health insurance; Heart failure; Hypertension; Menopausal symptoms; Coronary heart disease; Heart failure; Menopause; Oophorectomy; Original; Original s; Patients; Risk factors; Sexes; Survival analysis; Womens health
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.13480

Aims Women with menopausal symptoms show evidence of accelerated epigenetic ageing, vascular aging and low‐grade systemic inflammation status. However, data are limited regarding menopausal symptoms and risk of heart failure (HF). We aimed to explore the impact of menopausal symptoms on risk of HF. Methods We included 14 340 symptomatic menopausal women without a history of coronary heart disease (CHD) or HF from the Taiwan National Health Insurance Research Database as the experimental cohort. We included 14 340 asymptomatic women matched for age and comorbidities as controls. We surveyed possible comorbidity‐attributable risks of HF and assessed whether menopausal symptoms play a role in risk of HF. Additional analyses were conducted to ascertain the association of CHD and HF in different risk factor burdens categories in both cohorts and CHD was applied as a sensitivity analysis. Results The incidence of HF was not significantly lower in the experimental than in the control cohort (4.87 vs. 5.06 per 1000 person‐years, P = 0.336). Participants with a higher comorbidity burden had a proportionally increased risk of HF and CHD in both cohorts. The burden of risk factors had a greater impact on risk of HF in the control than in the experimental cohort (≥five risk factors, adjusted hazard ratio 25.69 vs. 14.75). Participants undergoing hormone therapy had no significant effect on the risk of HF, regardless of the presence or absence of menopausal symptoms. Subgroup analysis revealed that compared with the control cohort, the risk of HF in the experimental cohort did not increase significantly in all subgroups. Conclusions Menopausal symptoms were associated with CHD risk but not with risk of HF. Traditional risk factors rather than menopausal symptoms play important roles in the HF risk among middle‐aged women.