Harvard-Affiliated Researchers Discover Link Between Infertility and Risk of Heart Failure in Women

A recent study published by Harvard affiliated-researchers in the Journal of the American College of Cardiology found infertility in women to be linked with a 16 percent increase in risk of heart failure.

The study — conducted by researchers at Massachusetts General Hospital with support from the American Heart Association and the National Institute of Health — analyzed data from more than 35,000 post-menopausal women.

The researchers found a statistically significant link between history of infertility and risk of heart failure with preserved ejection fraction, HFpEF, however no such link was found between infertility and heart failure with reduced ejection fraction, HFrEF.

Though HFpEF and HFrEF are both forms of heart failure, HFpEF differs from HFrEF in the amount of blood pumped from the left ventricle of the heart per beat, or the ejection fraction. The difference in ejection fraction lends itself to a difference in risk factors and mortality rates.

Emily S. Lau, an instructor at Harvard Medical School who was the study’s first author, said researchers don’t understand why HFpEF “is incredibly prevalent among women,” adding that “we don't have good therapies for that type of heart failure.”

Lau said there is “a big black box” around infertility research, even though national estimates show that roughly 15 percent of American women experience infertility.

Researchers have done some work in the past that showed a link between infertility and cardiovascular disease, according to Lau. Before the new study was published in JACC, however, Lau said “the investigations had been very small in scale, and the data really had been quite mixed.”

“There’s a lot of room for investigation,” Lau said. “Trying to connect a woman’s reproductive history with her future risk of cardiovascular disease — specifically with this form of heart failure — is really important to me, and, I think, something that will guide clinical practice for many cardiologists and primary care physicians.”

“We, actually, as a medical community need to be asking our women patients about their reproductive histories in a systematic way,” Lau added.

Lau said she and other researchers are interested in understanding the mechanisms driving the link between infertility and risk of heart disease.

“I think we have a lot of room to go in terms of better understanding this relationship,” Lau said.