Extreme concentrations of endogenous sex hormones, ischemic heart disease, and death in women

Marianne Benn; Sidsel Skou Voss; Haya N. Holmegard; Gorm B. Jensen; Anne Tybjærg-Hansen; Børge G. Nordestgaard

doi:10.1161/atvbaha.114.304821

Extreme concentrations of endogenous sex hormones, ischemic heart disease, and death in women

Marianne Benn, Sidsel Skou Voss, Haya N. Holmegard, Gorm B. Jensen, Anne Tybjærg-Hansen, Børge G. Nordestgaard^*

^*Corresponding author for this work

Department of Clinical Medicine

31 Citations (Scopus)

Abstract

OBJECTIVE - : Sex hormones may be critical determinants of ischemic heart disease and death in women, but results from previous studies are conflicting. To clarify this, we tested the hypothesis that extreme plasma concentrations of endogenous estradiol and testosterone are associated with risk of ischemic heart disease and death in women. APPROACH AND RESULTS - : In a nested prospective cohort study, we measured plasma estradiol in 4600 and total testosterone in 4716 women not receiving oral contraceptives or hormonal replacement therapy from the 1981 to 1983 examination of the Copenhagen City Heart Study. During ≤30 years of follow-up, 1013 women developed ischemic heart disease and 2716 died. In women with a plasma estradiol below the fifth percentile compared with between the 10th and 89th percentiles, multifactorially adjusted risk of ischemic heart disease was 44% (95% confidence interval, 14%-81%) higher; however, plasma estradiol concentrations did not associate with death. Also, in women with a plasma testosterone concentration at or above the 95th percentile compared with between the 10th and 89th percentiles, multifactorially adjusted risk was 68% (34%-210%) higher for ischemic heart disease, 36% (18%-58%) higher for any death, and 38% (15%-65%) higher for death from other causes than cardiovascular disease and cancer. These results were similar for postmenopausal women alone. CONCLUSIONS - : In women, extreme low concentrations of endogenous estradiol were associated with high risk of ischemic heart disease, and extreme high concentrations of endogenous testosterone were associated with high risk of ischemic heart disease and death.

Original language	English
Journal	Arteriosclerosis, Thrombosis, and Vascular Biology
Volume	35
Issue number	2
Pages (from-to)	471-477
Number of pages	7
ISSN	1079-5642
DOIs	https://doi.org/10.1161/atvbaha.114.304821
Publication status	Published - 2 Feb 2015

Keywords

death
epidemiology
estrogens
general social development and population
gonadal steroid hormones
myocardial infarction
myocardial ischemia
testosterone

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1161/atvbaha.114.304821

ATVBAHA.114.304821Final published version, 716 KB

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title = "Extreme concentrations of endogenous sex hormones, ischemic heart disease, and death in women",

abstract = "OBJECTIVE - : Sex hormones may be critical determinants of ischemic heart disease and death in women, but results from previous studies are conflicting. To clarify this, we tested the hypothesis that extreme plasma concentrations of endogenous estradiol and testosterone are associated with risk of ischemic heart disease and death in women. APPROACH AND RESULTS - : In a nested prospective cohort study, we measured plasma estradiol in 4600 and total testosterone in 4716 women not receiving oral contraceptives or hormonal replacement therapy from the 1981 to 1983 examination of the Copenhagen City Heart Study. During ≤30 years of follow-up, 1013 women developed ischemic heart disease and 2716 died. In women with a plasma estradiol below the fifth percentile compared with between the 10th and 89th percentiles, multifactorially adjusted risk of ischemic heart disease was 44% (95% confidence interval, 14%-81%) higher; however, plasma estradiol concentrations did not associate with death. Also, in women with a plasma testosterone concentration at or above the 95th percentile compared with between the 10th and 89th percentiles, multifactorially adjusted risk was 68% (34%-210%) higher for ischemic heart disease, 36% (18%-58%) higher for any death, and 38% (15%-65%) higher for death from other causes than cardiovascular disease and cancer. These results were similar for postmenopausal women alone. CONCLUSIONS - : In women, extreme low concentrations of endogenous estradiol were associated with high risk of ischemic heart disease, and extreme high concentrations of endogenous testosterone were associated with high risk of ischemic heart disease and death.",

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author = "Marianne Benn and Voss, {Sidsel Skou} and Holmegard, {Haya N.} and Jensen, {Gorm B.} and Anne Tybj{\ae}rg-Hansen and Nordestgaard, {B{\o}rge G.}",

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AU - Benn, Marianne

AU - Voss, Sidsel Skou

AU - Holmegard, Haya N.

AU - Jensen, Gorm B.

AU - Tybjærg-Hansen, Anne

AU - Nordestgaard, Børge G.

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N2 - OBJECTIVE - : Sex hormones may be critical determinants of ischemic heart disease and death in women, but results from previous studies are conflicting. To clarify this, we tested the hypothesis that extreme plasma concentrations of endogenous estradiol and testosterone are associated with risk of ischemic heart disease and death in women. APPROACH AND RESULTS - : In a nested prospective cohort study, we measured plasma estradiol in 4600 and total testosterone in 4716 women not receiving oral contraceptives or hormonal replacement therapy from the 1981 to 1983 examination of the Copenhagen City Heart Study. During ≤30 years of follow-up, 1013 women developed ischemic heart disease and 2716 died. In women with a plasma estradiol below the fifth percentile compared with between the 10th and 89th percentiles, multifactorially adjusted risk of ischemic heart disease was 44% (95% confidence interval, 14%-81%) higher; however, plasma estradiol concentrations did not associate with death. Also, in women with a plasma testosterone concentration at or above the 95th percentile compared with between the 10th and 89th percentiles, multifactorially adjusted risk was 68% (34%-210%) higher for ischemic heart disease, 36% (18%-58%) higher for any death, and 38% (15%-65%) higher for death from other causes than cardiovascular disease and cancer. These results were similar for postmenopausal women alone. CONCLUSIONS - : In women, extreme low concentrations of endogenous estradiol were associated with high risk of ischemic heart disease, and extreme high concentrations of endogenous testosterone were associated with high risk of ischemic heart disease and death.

AB - OBJECTIVE - : Sex hormones may be critical determinants of ischemic heart disease and death in women, but results from previous studies are conflicting. To clarify this, we tested the hypothesis that extreme plasma concentrations of endogenous estradiol and testosterone are associated with risk of ischemic heart disease and death in women. APPROACH AND RESULTS - : In a nested prospective cohort study, we measured plasma estradiol in 4600 and total testosterone in 4716 women not receiving oral contraceptives or hormonal replacement therapy from the 1981 to 1983 examination of the Copenhagen City Heart Study. During ≤30 years of follow-up, 1013 women developed ischemic heart disease and 2716 died. In women with a plasma estradiol below the fifth percentile compared with between the 10th and 89th percentiles, multifactorially adjusted risk of ischemic heart disease was 44% (95% confidence interval, 14%-81%) higher; however, plasma estradiol concentrations did not associate with death. Also, in women with a plasma testosterone concentration at or above the 95th percentile compared with between the 10th and 89th percentiles, multifactorially adjusted risk was 68% (34%-210%) higher for ischemic heart disease, 36% (18%-58%) higher for any death, and 38% (15%-65%) higher for death from other causes than cardiovascular disease and cancer. These results were similar for postmenopausal women alone. CONCLUSIONS - : In women, extreme low concentrations of endogenous estradiol were associated with high risk of ischemic heart disease, and extreme high concentrations of endogenous testosterone were associated with high risk of ischemic heart disease and death.

KW - death

KW - epidemiology

KW - estrogens

KW - general social development and population

KW - gonadal steroid hormones

KW - myocardial infarction

KW - myocardial ischemia

KW - testosterone

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ER -

Extreme concentrations of endogenous sex hormones, ischemic heart disease, and death in women

Abstract

Keywords

UN SDGs

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