{"id":"017c7a91636a","type":"article","url":"https://hartvaat.nl/2026/05/25/koreaanse-studie-van-3-7-miljoen-postmenopauzale-vrouwen-hormonale-levensloop-vo/","title":"Koreaanse studie van 3,7 miljoen postmenopauzale vrouwen: hormonale levensloop voorspelt hartfalen-risico","title_en":"","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts","internist"],"tags":["acuut-hartfalen","menopauze","vrouwen"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehag380","source_url":"https://doi.org/10.1093/eurheartj/ehag380","authors":["Log Young Kim","Jin-Sung Yuk","Byung Gyu Kim"],"significance":7,"published":"2026-06-01","source_date":"2026-05-25","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/","https://hartvaat.nl/kennis/cardiometabool/obesitas-en-hart/"],"congress":"","summary_en":"Nationwide Korean cohort of 3,692,157 postmenopausal women without prior heart failure or structural heart disease, followed for a median of 120 months. During follow-up, 48,640 women were hospitalised for heart failure. Prior oral contraceptive use (≥1 year; SHR 0.942) and menopausal hormone therapy (≥5 years; SHR 0.782) were associated with lower HF risk. Later menarche (≥17 years), earlier menopause (40-44 years) and shorter total reproductive period (<30 years) were associated with higher risk (all p<0.001). Among women who developed HF, OC and MHT use also reduced mortality. Conclusion: longer lifetime exposure to endogenous and exogenous oestrogens protects against HF incidence and mortality.","created":"2026-07-03T10:32:59Z","updated":"2026-07-03T18:39:34Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Landelijke Koreaanse cohortstudie van 3.692.157 postmenopauzale vrouwen zonder voorafgaande hartfalen of structurele hartziekte, gevolgd over een mediaan van 120 maanden. Tijdens follow-up werden 48.640 vrouwen voor hartfalen opgenomen. Eerder gebruik van orale anticonceptie (≥1 jaar; SHR 0,942) en menopauzale hormoontherapie (≥5 jaar; SHR 0,782) was geassocieerd met lager hartfalen-risico. Latere menarche (≥17 jaar), vroegere menopauze (40-44 jaar) en kortere totale reproductieve periode (<30 jaar) waren geassocieerd met hoger risico (alle p<0,001). Onder vrouwen die wél hartfalen ontwikkelden, gaven OC- en HST-gebruik tevens een lagere sterfte. Conclusie: langere levenslange blootstelling aan endogene én exogene oestrogenen beschermt tegen hartfalen-incidentie en sterfte.","abstract_original":"BACKGROUND AND AIMS: Evidence on the association between female-specific factors and heart failure (HF) remains limited. This study examined their associations with HF and subsequent mortality. METHODS: Using the Korean National Health Insurance Service database, 3 692 157 postmenopausal women without prior HF or structural heart disease and with intact ovaries and uterus were identified. Associations between reproductive factors, including parity, breastfeeding duration, oral contraceptive (OC) and menopausal hormone therapy (MHT) use, age at menarche, age at menopause, and total reproductive period, and HF risk were assessed using Fine-Gray competing risk models, with death treated as a competing event. Among women with HF hospitalization, associations between reproductive factors and mortality were evaluated using multivariable Cox regression. RESULTS: During a median follow-up of 120 months, 48 640 women were hospitalized for HF. OC (sub-distribution hazard ratios [SHRs]≥1y vs non-user: 0.942, 99.3% confidence interval [CI] 0.896-0.990) or MHT (SHR≥5y vs non-user: 0.782 [99.3% CI 0.708-0.863]) use was associated with a lower HF risk. Later menarche (SHRage≥17 vs 13-16y: 1.099 [99.3% CI 1.071-1.128]), earlier menopause (SHRage 40-44y vs 50-54y: 1.229 [99.3% CI 1.173-1.288]), and shorter reproductive period (SHRage <30y vs ≥40y: 1.284 [99.3% CI 1.213-1.361]) were linked to higher HF risk (all P for trend <.001). Among women with HF, OC, and MHT use were associated with lower mortality, while earlier menarche, earlier menopause, and shorter reproductive period were linked to increased mortality. CONCLUSIONS: Prolonged lifetime exposure to both endogenous and exogenous female sex hormones is associated with lower HF incidence and subsequent mortality."}