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Background  The American Heart Association developed the Life’s Simple 7 metric for defining cardiovascular health. Little is known, however, whether co-occurring reproductive factors, which affects endogenous oestrogen levels during a woman’s life, also influences ideal cardiovascular health in postmenopausal women.    Methods  Using data on a cross-sectional study with a convenience sample of 1,625 postmenopausal women (median age, 60.0 years) in a medical health checkup program at a general hospital in central south China 2013–2014, we examined the association between cumulative reproductive risk and ideal cardiovascular health in postmenopausal women. A cumulative risk score (range 0 to 4) was created by summing four reproductive risk factors (age at menarche, age at menopause, number of children, and pregnancy losses) present in each individual from binary variables in which 0 stands for favorable and 1 for less-than-favorable level. Ideal levels for each component in Life’s Simple 7 (blood pressure, cholesterol, glucose, BMI, smoking, physical activity, and diet) were used to create an ideal Life’s Simple 7 score [0–1 (low), 2, 3, 4, 5 and 6–7 (high)].    Results  Participants with earlier age at menarche (odds ratio [OR] =0.42 [95 % CI 0.26-0.48]), earlier age at menopause [0.46 (0.32-0.58)], who have more than three children (0.42 [0.38-0.56]) and have history of pregnancy losses [0.76 (0.66-0.92)] were more likely to attain low (0–1) ideal Life’s Simple 7 after adjustment for age. Participants were more likely to attain low (0–1) ideal Life’s Simple 7 as exposure to the number of reproductive risk factors increased [OR (95 % CI) of 0.52 (0.42-0.66), 0.22 (0.16-0.26), and 0.16 (0.12-0.22) for cumulative reproductive risk scores of 1, 2, and 3 or 4, respectively, each versus 0].    Conclusions  The postmenopausal Chinese women with an increasing number of reproductive risk factors were progressively less likely to attain ideal levels of cardiovascular health factors.

Cumulative effect of reproductive factors on ideal cardiovascular health in postmenopausal women: a cross-sectional study in central south China