Association between reproductive history, healthy lifestyle and cardiovascular disease in rural women with hypertension

Objective: To explore the relationship between reproductive factors, healthy lifestyles, and the risk of cardiovascular disease (CVD) among rural women aged 65 years and older with hypertension, and to provide key evidence for primary prevention practices for CVD in this population.

Methods: A total of 10726 women with hypertension aged 65 and above in a county in Henan Province were selected in 2023 through face-to-face interview and physical examination. Reproductive factors included number of pregnancies, number of live births and history of miscarriage. Healthy lifestyle factors included sleep, diet, physical activity, passive smoking and BMI. Chi-square test was used for univariate analysis, and unconditional logistic regression was used to analyze the effects of reproductive factors, healthy lifestyle factors and their combination on the risk of CVD.

Results: The effective sample size of the study was 9,837, with 3,980 patients with CVD. Logistic regression results showed that compared with those with 0-2 pregnancies, those ≥5 pregnancies had an increased risk of CVD by 19.8% (OR=1.198?95%CI?1.057-1.359); those with a history of miscarriage had a 26.1% increased risk of CVD compared with those without a history of miscarriage (OR=1.261?95%CI?1.151-1.381), and the number of live births did not show a statistical difference. Compared with those with a healthy lifestyle score of 0-1, those with scores of 4-5 had a 27.4% (OR=0.716?95%CI?0.592-0.866) decrease in the risk of CVD. The risk of CVD was significantly increased by a combination of the number of pregnancies and healthy lifestyle. There was a significant joint effect, with 3-4 and ≥5 pregnancies showing a trend of increasing risk of CVD with decreasing healthy lifestyle scores. The healthy lifestyle score was negatively associated with the risk of CVD, regardless of whether there was a history of miscarriage.

Conclusion: Female hypertensive patients aged 65 years and above with a high number of pregnancies, a history of miscarriage and less healthy lifestyles are the key populations for CVD prevention and control in Henan Province, and should be strengthened and upgraded with education on healthy lifestyles to promote the implementation of primary prevention.

She is a third-year Master's student in Public Health at Zhengzhou University, China, specializing in chronic disease epidemiology and prevention. Her research focuses on risk factor analysis and intervention strategies for non-communicable diseases. Currently, she is leading data analysis in a university-level graduate innovation project investigating behavioural determinants of chronic conditions. Her academic contributions were recognized with a third prize in the National Medical Science Popularization Essay Competition, demonstrating her ability to communicate complex epidemiological concepts effectively. Through this conference, She is to exchange insights on innovative approaches to chronic disease control and contribute to global health discourse.