Abstract 17928: Parity, Job Stress, and Cardiovascular Risk in the Women’s Health Study
Background: Reproductive milestones and employment are critical events in a woman’s life that can affect chronic disease risk. Hence, we examined the relationship between parity and cardiovascular risk, and whether this association is affected by job stress.
Methods and Results: Cox proportional hazard models examined the association of parity with cardiovascular disease (CVD) risk [myocardial infarction (MI), coronary artery revascularization, ischemic stroke, and CVD death] in 16,763 participants in the Women’s Health Study. Among employed women, we also evaluated whether job stress moderated the parity-CVD relationship. Parity was defined at baseline as pregnancy lasting >6 months gestation, categorized as none (referent), 1-2, 3-4, and 5+. Job strain at year five of observational follow-up was operationalized using the Karasek job strain model, and job insecurity was defined based on the item “my job security is good” (yes or no). Mean age of the women at baseline was 51.9 ±4.8 years and after an average follow-up of 19 years was 70.8 ±4.8 years. In models adjusted for age, race/ethnicity, income, education, CVD risk factors, and age of menarche, increasing parity was associated with increased CVD risk compared to no pregnancies [Hazard Ratio (HR), 95% Confidence Interval (CI): 1.27, 0.98-1.65 (1-2); 1.61, 1.24-2.08 (3-4); 1.86, 1.37-2.52 (5+)]. Further adjustment for job strain revealed little attenuation in the noted relationship (HR, 95% CI: 1.28, 0.98-1.66 (1-2); 1.61, 1.24-2.08 (3-4); 1.86, 1.37-2.51 (5+)). Examination of interaction between job strain (p =0.46) or job insecurity (p =0.51) and parity did not reveal any moderating effects, as would be expected given their low association (Spearman correlation = -0.02). In a subsample of women with measures of C-reactive protein (CRP; N=12,558), increasing parity is significantly associated with higher CRP levels (p < 0.001), and adjustment for CRP levels in fully adjusted models eliminated the observed association between parity and CVD risk.
Conclusion: Among working women, increased parity was related to heightened CVD risk, a relationship that is not moderated by job strain, but appears to be mediated by heightened inflammation.
Author Disclosures: E.M. Durazo: None. T. Cabeza de Baca: None. N. Slopen: None. D.R. Williams: None. A.M. Zaslavsky: None. J.E. Buring: None. M.A. Albert: None.
- © 2016 by American Heart Association, Inc.