title: Fatherhood and the risk of cardiovascular mortality in the NIH-AARP Diet and Health Study.
abstract: BACKGROUND
  Fertility potential and reproductive fitness may reflect a man's future health, given that over one-third of the male human genome is involved in reproduction. We sought to determine if offspring number predicts cardiovascular death in the US men.
  
  
  METHODS
  Using data from the NIH-AARP Diet and Health Study, 137,903 men (aged 50-71) without prior cardiovascular disease were followed-up for an average of 10.2 years. International Classification of Diseases, ninth edition, codes were used to establish the cause of death, and multivariable Cox proportional hazards modeling was used to estimate the association between offspring number and cardiovascular death while accounting for sociodemographic and lifestyle characteristics.
  
  
  RESULTS
  Almost all (92%) participants had fathered at least one child and 50% had three or more offspring. A total of 3082 men died of cardiovascular causes during follow-up for an age-adjusted incidence rate of 2.70 per 1000 person-years. Compared with fathers, after adjusting for sociodemographic and lifestyle factors, childless men had a 17% [hazard ratio (HR): 1.17; 95% confidence interval (CI): 1.03-1.32] increased risk of death from cardiovascular disease contracted in the study period, and this elevated risk appeared to extend also to men with only one child. In comparison with fathers of five or more children, adjusted relative hazards for cardiovascular mortality of this sort were 1.06 (95% CI: 0.92-1.22) for four children, 1.02 (0.90-1.16) for three children, 1.02 (0.90-1.16) for two children, 1.11 (0.95-1.30) for one child and 1.21 (1.03-1.41) for no children.
  
  
  CONCLUSIONS
  Married men who have no children have a higher risk of dying from cardiovascular disease contracted after the age of 50 than men with two or more children.
authors.affiliation: Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305-5118, USA. eisenberg@stanford.edu
authors.forename: Michael L
authors.initials: ML
authors.lastname: Eisenberg
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Albert R
authors.initials: AR
authors.lastname: Hollenbeck
authors.forename: Larry I
authors.initials: LI
authors.lastname: Lipshultz
authors.forename: Arthur
authors.initials: A
authors.lastname: Schatzkin
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Pletcher
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D002423:Cause of Death; D005298:Fertility; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D012307:Risk Factors; D014481:United States / Q000453:epidemiology