title: Cumulative effect of reproductive factors on ideal cardiovascular health in postmenopausal women: a cross-sectional study in central south China.
abstract: BACKGROUND
  The American Heart Association developed the Life's Simple 7 metric for defining cardiovascular health. Little is known, however, whether co-occurring reproductive factors, which affects endogenous oestrogen levels during a woman's life, also influences ideal cardiovascular health in postmenopausal women.
  
  
  METHODS
  Using data on a cross-sectional study with a convenience sample of 1,625 postmenopausal women (median age, 60.0 years) in a medical health checkup program at a general hospital in central south China 2013-2014, we examined the association between cumulative reproductive risk and ideal cardiovascular health in postmenopausal women. A cumulative risk score (range 0 to 4) was created by summing four reproductive risk factors (age at menarche, age at menopause, number of children, and pregnancy losses) present in each individual from binary variables in which 0 stands for favorable and 1 for less-than-favorable level. Ideal levels for each component in Life's Simple 7 (blood pressure, cholesterol, glucose, BMI, smoking, physical activity, and diet) were used to create an ideal Life's Simple 7 score [0-1 (low), 2, 3, 4, 5 and 6-7 (high)].
  
  
  RESULTS
  Participants with earlier age at menarche (odds ratio [OR] =0.42 [95 % CI 0.26-0.48]), earlier age at menopause [0.46 (0.32-0.58)], who have more than three children (0.42 [0.38-0.56]) and have history of pregnancy losses [0.76 (0.66-0.92)] were more likely to attain low (0-1) ideal Life's Simple 7 after adjustment for age. Participants were more likely to attain low (0-1) ideal Life's Simple 7 as exposure to the number of reproductive risk factors increased [OR (95 % CI) of 0.52 (0.42-0.66), 0.22 (0.16-0.26), and 0.16 (0.12-0.22) for cumulative reproductive risk scores of 1, 2, and 3 or 4, respectively, each versus 0].
  
  
  CONCLUSIONS
  The postmenopausal Chinese women with an increasing number of reproductive risk factors were progressively less likely to attain ideal levels of cardiovascular health factors.
authors.affiliation: Department of Health Management Center, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, Hunan Province, 410013, China. cxiacsu@csu.edu.cn.
authors.forename: Xia
authors.initials: X
authors.lastname: Cao
authors.affiliation: Mental Health Institute, the Second Xiangya Hospital, the Central South University, Changsha, Hunan Province, China. 25209247@qq.com.
authors.forename: Jiansong
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Clinical Pharmacology Center, the Third Xiangya Hospital, the Central South University, Changsha, Hunan Province, China. 17368895@qq.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Yuan
authors.affiliation: Department of Health Management Center, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, Hunan Province, 410013, China. cx_csu@163.com.
authors.forename: Zhiheng
authors.initials: Z
authors.lastname: Chen
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D002681:China / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects; D005260:Female; D006304:Health Status; D006769:Hospitals, General; D006801:Humans; D008019:Life Style; D008572:Menarche; D008875:Middle Aged; D009043:Motor Activity; D010298:Parity; D017698:Postmenopause; D011247:Pregnancy; D012098:Reproduction; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016387:Women's Health
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002784:Cholesterol