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<h5 class="section-title" id="d339313e263">Background</h5>
<p id="P1">Higher androgen and lower estrogen levels are associated with cardiovascular
disease
(CVD) risk factors in women. However, studies on sex hormones and incident CVD events
in women have yielded conflicting results.
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<h5 class="section-title" id="d339313e268">Objectives</h5>
<p id="P2">We assessed the associations of sex hormone levels with incident CVD, coronary
heart
disease (CHD), and heart failure (HF) events among women without CVD at baseline.
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<h5 class="section-title" id="d339313e273">Methods</h5>
<p id="P3">We studied 2,834 post-menopausal women participating in MESA with testosterone,
estradiol,
dehydroepiandrosterone, and sex hormone binding globulin (SHBG) levels measured at
baseline (2000–2002). We used Cox hazard models to evaluate associations of sex hormones
with each outcome, adjusting for demographics, CVD risk factors, and hormone therapy
use.
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<h5 class="section-title" id="d339313e278">Results</h5>
<p id="P4">The mean (SD) age was 64.9 (8.9) years. During 12.1 years of follow-up,
283 CVD, 171
CHD, and 103 HF incident events occurred. In multivariable-adjusted models, the Hazard
Ratios (95% CI) associated with 1 SD greater log-transformed sex hormone level for
the respective outcomes of CVD, CHD, and HF were as follows: Total testosterone: 1.14
(1.01–1.29), 1.20 (1.03–1.40), 1.09 (0.90–1.34); Estradiol: 0.94 (0.80–1.11), 0.77
(0.63–0.95), 0.78 (0.60–1.02); Testosterone/Estradiol ratio: 1.19 (1.02–1.40), 1.45
(1.19–1.78), 1.31 (1.01–1.70). Dehydroepiandrosterone and SHBG levels were not associated
with these outcomes.
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<h5 class="section-title" id="d339313e283">Conclusions</h5>
<p id="P5">Among post-menopausal women, a higher testosterone/estradiol ratio was
associated
with an elevated risk for incident CVD, CHD, and HF events, higher levels of testosterone
associated with increased CVD and CHD, while higher estradiol levels were associated
with a lower CHD risk. Sex hormones levels after menopause are associated with women’s
increased CVD risk later in life.
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<h5 class="section-title" id="d339313e288">Condensed abstract</h5>
<p id="P6">We studied 2,834 post-menopausal women in the Multi-Ethnic Study of Atherosclerosis.
Higher total testosterone/estradiol ratio was independently associated with an elevated
risk for incident CVD, CHD, and HF events. After >12 years of follow-up, the multivariable-adjusted
Hazard Ratios (95% CI) associated with 1 SD greater log-transformed total testosterone/estradiol
ratio for incident CVD, CHD and HF events were 1.19 (1.02–1.40), 1.45 (1.19–1.78),
1.31 (1.01–1.70), respectively. Sex hormones levels after menopause are associated
with women’s increased CVD risk later in life.
</p>
</div>