System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Ppublish 18 citations

PubMed: 38528787 DOI: 10.1002/ejhf.3189

Pre-diagnostic free androgen and estradiol levels influence heart failure risk in both women and men: A prospective cohort study in the UK Biobank.

Eur J Heart Fail 26(3):540-550

Authors: Jungeun Lim, Maryam Hashemian, Batel Blechter, VĂ©ronique L Roger, Jason Y Y Wong

Affiliations

  • Epidemiology and Community Health Branch, National Heart Lung and Blood Institute, Bethesda, MD, USA.
  • Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.

Abstract

AIMS

Serum sex hormones have been linked to cardiovascular disease risk. However, their roles in the pathogenesis of heart failure (HF) in both men and women are unclear. We investigated the associations between free androgen, testosterone, and estradiol, and future risk of HF.

METHODS AND RESULTS

This prospective cohort study evaluated UK Biobank participants free of prevalent cardiovascular disease and HF at baseline. Unitless free androgen, testosterone, and estradiol indices were generated using serum concentrations of total testosterone (nmol/L), estradiol (pmol/L), sex hormone binding globulin (SHBG, nmol/L), and albumin (g/L) in blood collected at enrolment. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident HF in relation to quartiles (Q) of free androgen (FAI), testosterone (FTI), estradiol (FEI) indices, and potential confounders. There were 180 712 men (including 5585 HF cases with FAI and 571 HF cases with FEI), and 177 324 women (including 2858 HF cases with FAI and 314 HF cases with FEI) with complete data. Increased FAI was associated with decreased HF risk in both men (HR Q4 vs. Q1: 0.86, 95% CI 0.79-0.94, p-trend continuous < 0.0001) and post-menopausal women (HR Q4 vs. Q1: 0.83, 95% CI 0.73-0.95). Similar inverse associations were observed for FTI only in men (HR Q4 vs. Q1: 0.91, 95% CI 0.83-0.98). Higher FEI was significantly associated with decreased HF risk among men (HR Q4 vs. Q1: 0.76, 95% CI 0.59-0.98), but was positively associated among pre-menopausal women (HR Q4 vs. Q1: 2.16, 95% CI 1.11-4.18).

CONCLUSIONS

Sex hormones potentially influence HF pathogenesis and may offer pathways for interventions.

MeSH

Estradiol, Heart Failure, Androgens, Heart, Cardiovascular Diseases, Cohort Studies, Hormones, Testosterone, Sex, Gonadal Steroid Hormones

Cited by