Association between the female hormone intake and coronary artery disease in the women: A study based on NHANES 1999-2020

Abstract

Although many studies have reported the relationship between female hormone intake and the coronary artery disease(CAD) development their association has not been elucidated and defined. Based on data from the Third National Health and Nutrition Examination Survey, this study assessed the relation between female hormone intake and the CAD development in 38745 eligible female participants. Many sociocultural determinants of health (SDOH) factors are significantly related to CAD occurrence and female hormone intake. Stratified analysis of SDOH factors showed that female hormone intake reduces the risk of CAD in women aged ≥ 60 years old. For women who received higher levels of education, female hormone intake is a risk factor for CAD. For women in poverty or wealth, female hormone intake is a risk factor for congestive heart failure and stroke, but it is a protective factor for the four clinical features of CAD for women in middle-income levels. Moreover, for women with menarche at 13–15 years old, menopause at 30–49 years old, and pregnancies 7–9 times, as well as with a low-sugar, low-fat, low-cholesterol diet and proper folic acid intake, female hormone intake have a protective effect on the development of CAD. We conclude that the appropriate female hormone intake plays a protective role in the occurrence of CAD, but it also exerts an adverse effect on CAD under a different SDOH background. It suggested that the patients must be rigorously screened for SODH background in clinical applications of female hormones to exert a protective effect on CAD.