Table 5.
Relative Risk and 95% Confidence Intervals of Total CVD According to Reproductive Life Span Factors Among the Nurses' Health Study Participants Who Never Used Hormone Therapy
| Reproductive Life Span (y) | ||||||
|---|---|---|---|---|---|---|
| <30 | 30 to 33 | 34 to 37 | 38 to 41 | ≥42 | P Trend | |
| Cases/person‐years | 147/26 304 | 263/62 343 | 733/186 061 | 916/228 432 | 296/76 234 | |
| Model 1a | 1.66 (1.36–2.03) | 1.27 (1.08–1.51) | 1.11 (0.97–1.27) | 1.05 (0.92–1.20) | 1 | <0.0001 |
| Model 2b | 1.40 (1.13–1.73) | 1.14 (0.96–1.35) | 1.05 (0.92–1.21) | 1.04 (0.91–1.19) | 1 | 0.003 |
| Model 3c | 1.41 (1.14–1.75) | 1.17 (0.99–1.40) | 1.08 (0.94–1.24) | 1.06 (0.93–1.21) | 1 | 0.002 |
| Age at Menarche (y) | ||||||||
|---|---|---|---|---|---|---|---|---|
| ≤10 | 11 | 12 | 13 | 14 | 15 | ≥16 | P Trend | |
| Cases/person‐years | 181/32 863 | 436/101 344 | 670/163 856 | 805/194 942 | 332/79 795 | 103/28 157 | 108/24 249 | |
| Model 1a | 1.46 (1.24–1.71) | 1.06 (0.95–1.20) | 1.00 (0.90–1.10) | 1 | 0.95 (0.84–1.08) | 0.84 (0.68–1.03) | 0.98 (0.80–1.20) | 0.0002 |
| Model 2b | 1.27 (1.08–1.49) | 1.01 (0.89–1.13) | 0.97 (0.87–1.07) | 1 | 0.99 (0.87–1.12) | 0.82 (0.67–1.01) | 0.96 (0.78–1.17) | 0.02 |
| Model 3c | 1.22 (1.03–1.44) | 0.98 (0.87–1.10) | 0.96 (0.86–1.06) | 1 | 0.99 (0.87–1.13) | 0.84 (0.68–1.03) | 0.97 (0.79–1.19) | 0.12 |
| Age at Menopause (y) | ||||||
|---|---|---|---|---|---|---|
| <40 | 40 to 44 | 45 to 49 | 50 to 54 | ≥55 | P Trend | |
| Cases/person‐years | 71/11 982 | 162/35 648 | 715/176 230 | 1223/305 832 | 184/49 682 | |
| Model 1a | 1.76 (1.38–2.24) | 1.38 (1.17–1.63) | 1.15 (1.04–1.26) | 1 | 0.89 (0.76–1.04) | <0.0001 |
| Model 2b | 1.43 (1.09–1.86) | 1.20 (1.02–1.43) | 1.06 (0.96–1.16) | 1 | 0.95 (0.81–1.11) | 0.001 |
| Model 3c | 1.36 (1.04–1.77) | 1.22 (1.03–1.44) | 1.06 (0.96–1.16) | 1 | 0.95 (0.81–1.11) | 0.002 |
CVD indicates cardiovascular disease.
P for interaction of hormone therapy use with reproductive life span, age at menarche, or age at menopause is >0.05. P for nonlinear trends between age at menarche and CVD are 0.03 (model 1), 0.30 (model 2), and 0.38 (model 3).
Model 1 age adjusted.
Model 2 additionally adjusted for ethnicity (European descent, Asian, Hispanic, or black), oral contraceptive use (never, ever), parity (nulliparous, 1–2, or ≥3), family history of myocardial infarction (excluded in stroke outcome analysis), family history of stroke (excluded in CHD outcome analysis), smoking (never, past, or current 1–14, 15–24, or ≥25 cigarettes/day), moderate‐to‐vigorous exercise (0, 0.01–1.0, 1.1–3.4, 3.5–5.9, or ≥6 h/week), Alternate Healthy Eating Index score (<45, 45 to <60, or ≥60), aspirin use (yes, no), alcohol intake (0, 0.1–4.9, 5.0–14.9, or ≥15.0 g/day), body mass index (BMI; <18.5, 18.5–22.4, 22.5–24.9, 25.0–27.4, 27.5–29.9, 30.0–34.9, or ≥35.0 kg/m2), BMI at age 18 years (<18.5, 18.5–22.4, 22.5–24.9, 25.0–27.4, 27.5–29.9, 30.0–34.9, or ≥35.0 kg/m2), and menopause type (natural, surgical).
Model 3 additionally adjusted for a history of diabetes mellitus, hypertension, and hypercholesterolemia.