Infertility and Subclinical Antecedents of Heart Failure with Preserved Ejection Fraction in the Framingham Heart Study
Heart failure with preserved ejection fraction (HFpEF) is a growing public health challenge, yet underlying mechanisms remain poorly understood. One consistent epidemiologic observation is that the prevalence of HFpEF is markedly higher in women than men. Recent evidence suggests that reproductive factors such as early age of menopause and nulliparity may contribute to the female susceptibility to HFpEF.1 Infertility, a common reproductive factor that affects over 15% of reproductive-aged women in the United States, is consistently underrecognized with respect to cardiovascular risk.