Association between the female hormone intake and cardiovascular disease in the women: a study based on NHANES 1999–2020

Although many studies have reported the relationship between female hormone intake and cardiovascular disease (CVD) development, their association has not been fully elucidated and defined, based on data from the Third National Health and Nutrition Examination Survey intending to assess the health and nutritional status of non-institutionalized children and adults in the United States. This study examined the relationship between female hormone intake and coronary artery disease (CVD) development in 38,745 women, averaging 38.10 ± 12.59 years in age. We explored the association between hormone intake and CVD incidence, considering various social determinants of health (SDOH) with statistical methods like Chi-square tests, logistic regression, and stratified Chi-square analysis. Our findings reveal a complex relationship between female hormone intake and CVD development. Hormones appear to reduce CVD risk in women over 60 years old. However, hormone intake correlates with increased CVD risk in highly educated women. Socioeconomic status also influences this relationship; while hormones pose a risk factor for heart failure and stroke in impoverished or wealthy women, they serve as a protective factor against CVD for middle-income women. Additionally, hormonal intake seems beneficial for women who experienced menarche between 13 and 15 years old, menopause between 30 and 49, and had 7-9 pregnancies, especially when coupled with a diet low in sugar, fat, cholesterol, and adequate folic acid intake. These results indicate that while hormones can prevent CVD under specific conditions, their impact can be detrimental in different SDOH contexts. In conclusion, while appropriate hormone intake can prevent CVD, its effects vary across different demographic and health backgrounds. This underscores the necessity for meticulous screening of SDOH factors in clinical settings to maximize the protective benefits of hormones against CVD.