Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

The association of reproductive history with hypertension and obesity according to menopausal status: the J-MICC Study

Hypertension Research volume 45, pages 708–714 (2022)Cite this article

Abstract

Previous studies have reported that the number of pregnancies and childbirths affected the risk of cardiovascular diseases (CVDs). However, the influence of reproductive history on hypertension and obesity, which are important risk factors for CVDs, is still unclear. Moreover, this association may vary depending on menopausal status. We evaluated the association of reproductive history with hypertension and obesity using a large cross-sectional dataset from the Japan Multi-Institutional Collaborative Cohort Study (J-MICC Study). At the baseline survey, physical data, blood samples, and self-reported health questionnaires were collected. Participants with insufficient data were excluded, and 24,558 women from eight study regions were included in this study. Logistic regression analysis was conducted to evaluate the association of reproductive history with hypertension and obesity using multivariable-adjusted odds ratios. In premenopausal women, childbirth showed a generally protective effect on hypertension but not on obesity. In postmenopausal women, childbirth was positively associated with obesity and hypertension but not with hypertension after adjusting for BMI. In conclusion, reproductive history was associated with hypertension and obesity in a large Japanese population, and this association differed between premenopausal and postmenopausal women.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

Similar content being viewed by others

References

  1. Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women–2011 update: a guideline from the american heart association. Circulation. 2011;123:1243–62.

    Article  Google Scholar 

  2. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140:e596–646.

    PubMed  PubMed Central  Google Scholar 

  3. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:e13–5.

    CAS  Google Scholar 

  4. Parikh NI, Cnattingius S, Dickman PW, Mittleman MA, Ludvigsson JF, Ingelsson E. Parity and risk of later-life maternal cardiovascular disease. Am Heart J. 2010;159:215–21.

    Article  Google Scholar 

  5. Otsuki S, Saito E, Sawada N, Abe SK, Hidaka A, Yamaji T, et al. Female reproductive factors and risk of all-cause and cause-specific mortality among women: The Japan Public Health Center-based Prospective Study (JPHC study). Ann Epidemiol. 2018;28:597–604.

    Article  Google Scholar 

  6. Tanigawa K, Ikehara S, Kimura T, Imano H, Muraki I, Shirai K, et al. Relationships Between Reproductive History and Mortality From Cardiovascular Diseases Among Japanese Women: The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study. J Epidemiol. 2020;30:509–15.

    Article  Google Scholar 

  7. Lv H, Wu H, Yin J, Qian J, Ge J. Parity and Cardiovascular Disease Mortality: a Dose-Response Meta-Analysis of Cohort Studies. Sci Rep. 2015;5:13411.

    Article  CAS  Google Scholar 

  8. Lawlor DA, Emberson JR, Ebrahim S, Whincup PH, Wannamethee SG, Walker M, et al. British Women’s Heart and Health Study, British Regional Heart Study. Is the association between parity and coronary heart disease due to biological effects of pregnancy or adverse lifestyle risk factors associated with child-rearing? Findings from the British Women’s Heart and Health Study and the British Regional Heart Study. Circulation. 2003;107:1260–4.

    Article  Google Scholar 

  9. Jang M, Lee Y, Choi J, Kim B, Kang J, Kim Y, et al. Association between Parity and Blood Pressure in Korean Women: Korean National Health and Nutrition Examination Survey, 2010-2012. Korean J Fam Med. 2015;36:341–8.

    Article  Google Scholar 

  10. Gunderson EP, Chiang V, Lewis CE, Catov J, Quesenberry CP Jr, Sidney S, et al. Long-term blood pressure changes measured from before to after pregnancy relative to nonparous women. Obstet Gynecol. 2008;112:1294–302.

    Article  Google Scholar 

  11. Ness RB, Kramer RA, Flegal KM. Gravidity, blood pressure, and hypertension among white women in the Second National Health and Nutrition Examination Survey. Epidemiology. 1993;4:303–9.

    Article  CAS  Google Scholar 

  12. Chen SX, Rasmussen KM, Finkelstein J, Stovring H, Nohr EA, Kirkegaard H. Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease: a Danish cohort study. BMJ Open. 2019;9:e030702.

    Article  Google Scholar 

  13. Erem C, Hacihasanoglu A, Kocak M, Deger O, Topbas M. Prevalence of prehypertension and hypertension and associated risk factors among Turkish adults: Trabzon Hypertension Study. J Public Health. 2009;31:47–58.

    Article  Google Scholar 

  14. Dratva J, Schneider C, Schindler C, Stolz D, Gerbase M, Pons M, et al. Is there a differential impact of parity on blood pressure by age? J Hypertens. 2014;32:2146–51.

    Article  CAS  Google Scholar 

  15. Giubertoni E, Bertelli L, Bartolacelli Y, Origliani G, Modena MG. Parity as predictor of early hypertension during menopausal transition. J Hypertens. 2013;31:501–7.

    Article  CAS  Google Scholar 

  16. Lao XQ, Thomas GN, Jiang CQ, Zhang WS, Yin P, Schooling M, et al. Parity and the metabolic syndrome in older Chinese women: the Guangzhou Biobank Cohort Study. Clin Endocrinol. 2006;65:460–9.

    Article  CAS  Google Scholar 

  17. Taylor JY, Chambers AN, Funnell B, Wu CY. Effects of parity on blood pressure among African-American women. J Natl Black Nurses Assoc. 2008;19:12–9.

    PubMed  PubMed Central  Google Scholar 

  18. Hamajima N, Group J-MS. The Japan Multi-Institutional Collaborative Cohort Study (J-MICC Study) to detect gene-environment interactions for cancer. Asian Pac J Cancer Prev. 2007;8:317–23.

    PubMed  Google Scholar 

  19. Takeuchi K, Naito M, Kawai S, Tsukamoto M, Kadomatsu Y, Kubo Y, et al. Study profile of the Japan Multi-institutional Collaborative Cohort (J-MICC) Study. J Epidemiol. 2020. https://doi.org/10.2188/jea.JE20200147.

  20. Tokudome Y, Goto C, Imaeda N, Hasegawa T, Kato R, Hirose K, et al. Relative validity of a short food frequency questionnaire for assessing nutrient intake versus three-day weighed diet records in middle-aged Japanese. J Epidemiol. 2005;15:135–45.

    Article  Google Scholar 

  21. Uemura H, Katsuura-Kamano S, Iwasaki Y, Arisawa K, Hishida A, Okada R, et al. Japan Multi-institutional Collaborative Cohort (J-MICC) Study Group. Independent relationships of daily life activity and leisure-time exercise with metabolic syndrome and its traits in the general Japanese population. Endocrine. 2019;64:552–63.

    Article  CAS  Google Scholar 

  22. Clapp JF 3rd, Capeless E. Cardiovascular function before, during, and after the first and subsequent pregnancies. Am J Cardiol. 1997;80:1469–73.

    Article  Google Scholar 

  23. Lupton SJ, Chiu CL, Lujic S, Hennessy A, Lind JM. Association between parity and breastfeeding with maternal high blood pressure. Am J Obstet Gynecol. 2013;208:454 e451–7.

    Article  Google Scholar 

  24. Ashraf MS, Vongpatanasin W. Estrogen and hypertension. Curr Hypertens Rep. 2006;8:368–76.

    Article  CAS  Google Scholar 

  25. Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA. 2003;290:199–206.

    Article  Google Scholar 

  26. Ouyang P, Michos ED, Karas RH. Hormone replacement therapy and the cardiovascular system lessons learned and unanswered questions. J Am Coll Cardiol. 2006;47:1741–53.

    Article  CAS  Google Scholar 

  27. Nagai K, Hayashi K, Yasui T, Katanoda K, Iso H, Kiyohara Y, et al. Disease history and risk of comorbidity in women’s life course: a comprehensive analysis of the Japan Nurses’ Health Study baseline survey. BMJ Open. 2015;5:e006360.

    Article  Google Scholar 

  28. Mu F, Rich-Edwards J, Rimm EB, Spiegelman D, Missmer SA. Endometriosis and Risk of Coronary Heart Disease. Circ Cardiovasc Qual Outcomes. 2016;9:257–64.

    Article  Google Scholar 

  29. Figuero E, Carrillo-de-Albornoz A, Martin C, Tobias A, Herrera D. Effect of pregnancy on gingival inflammation in systemically healthy women: a systematic review. J Clin Periodontol. 2013;40:457–73.

    Article  CAS  Google Scholar 

  30. Lockhart PB, Bolger AF, Papapanou PN, Osinbowale O, Trevisan M, Levison ME, et al. American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, Council on Epidemiology and Prevention, Council on Peripheral Vascular Disease, and Council on Clinical Cardiology. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association. Circulation. 2012;125:2520–44.

    Article  Google Scholar 

  31. Gordon JH, LaMonte MJ, Genco RJ, Zhao J, Cimato TR, Hovey KM, et al. Association of clinical measures of periodontal disease with blood pressure and hypertension among postmenopausal women. J Periodontol. 2018;89:1193–202.

    Article  Google Scholar 

  32. Segovia SA, Vickers MH, Reynolds CM. The impact of maternal obesity on inflammatory processes and consequences for later offspring health outcomes. J Dev Orig Health Dis. 2017;8:529–40.

    Article  CAS  Google Scholar 

  33. Pendeloski KPT, Ono E, Torloni MR, Mattar R, Daher S. Maternal obesity and inflammatory mediators: a controversial association. Am J Reprod Immunol. 2017;77:e12674.

    Article  Google Scholar 

  34. Hisamatsu T, Segawa H, Kadota A, Ohkubo T, Arima H, Miura K. Epidemiology of hypertension in Japan: beyond the new 2019 Japanese guidelines. Hypertens Res. 2020;43:1344–51.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank all the participants of the baseline survey of the J-MICC Study, Drs. Nobuyuki Hamajima and Hideo Tanaka (former principal investigators), and the staff in each study region for their cooperation.

the Japan Multi-institutional Collaborative Cohort (J-MICC) Study Group

Kenji Wakai6, Kenji Takeuchi6, Hiroki Nagase19, Haruo Mikami17, Hiroto Narimatsu20, Kiyonori Kuriki11, Sadao Suzuki10, Keitaro Matsuo15, Asahi Hishida6, Yoshikuni Kita18, Katsuyuki Miura1, Teruhide Koyama9, Kokichi Arisawa12, Hiroaki Ikezaki14, Keitaro Tanaka7, Toshiro Takezaki8.

Funding

This study was supported by Grants-in-Aid for Scientific Research on Priority Areas of Cancer (No. 17015018), Innovative Areas (No. 221S0001), and Platform of Supporting Cohort Study and Biospecimen Analysis (JSPS KAKENHI Grant Number JP16H06277[CoBiA]) from the Japanese Ministry of Education, Culture, Sports, Science and Technology. This work was also supported in part by a Grant-in-Aid from the Japan Society for the Promotion of Science (JSPS KAKENHI Grant Numbers 24390165, 20390184, 17390186, 19H03902).

Author information

Authors and Affiliations

  1. Department of Public Health, Shiga University of Medical Science, Otsu, Japan

    Mizuki Ohashi, Katsuyuki Miura, Aya Kadota & Katsuyuki Miura

  2. Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Japan

    Mizuki Ohashi, Shunichiro Tsuji & Takashi Murakami

  3. NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan

    Katsuyuki Miura & Aya Kadota

  4. Department of Public Health, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan

    Naoyuki Takashima

  5. Department of Health Science, Aino University, Osaka, Japan

    Yoshino Saito

  6. Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yuka Kadomatsu, Mako Nagayoshi, Takashi Tamura, Asahi Hishida, Kenji Takeuchi, Kenji Wakai, Kenji Takeuchi & Asahi Hishida

  7. Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan

    Megumi Hara & Keitaro Tanaka

  8. Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

    Toshiro Takezaki & Ippei Shimoshikiryo

  9. Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Etsuko Ozaki, Isao Watanabe & Teruhide Koyama

  10. Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Sadao Suzuki & Miki Watanabe

  11. Laboratory of Public Health, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan

    Kiyonori Kuriki

  12. Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan

    Kokichi Arisawa & Sakurako Katsuura-Kamano

  13. Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan

    Sho Yamasaki & Hiroaki Ikezaki

  14. Department of Comprehensive General Internal Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan

    Hiroaki Ikezaki & Hiroaki Ikezaki

  15. Division of Cancer Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Japan

    Isao Oze & Keitaro Matsuo

  16. Division of Cancer Information and Control, Aichi Cancer Center, Nagoya, Japan

    Yuriko N. Koyanagi

  17. Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan

    Haruo Mikami & Yohko Nakamura

  18. Faculty of Nursing Science, Tsuruga Nursing University, Tsuruga, Japan

    Yoshikuni Kita

  19. Chiba Cancer Center Research Institute, Chiba, Japan

    Hiroki Nagase

  20. Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa, Japan

    Hiroto Narimatsu

Authors
  1. Mizuki Ohashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katsuyuki Miura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Naoyuki Takashima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aya Kadota
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshino Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shunichiro Tsuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takashi Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yuka Kadomatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mako Nagayoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Megumi Hara
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Keitaro Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Takashi Tamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Asahi Hishida
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Toshiro Takezaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Ippei Shimoshikiryo
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Etsuko Ozaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Isao Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Sadao Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Miki Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Kiyonori Kuriki
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Kokichi Arisawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Sakurako Katsuura-Kamano
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Sho Yamasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Hiroaki Ikezaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. Isao Oze
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. Yuriko N. Koyanagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. Haruo Mikami
    View author publications

    You can also search for this author in PubMed Google Scholar

  28. Yohko Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  29. Kenji Takeuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  30. Yoshikuni Kita
    View author publications

    You can also search for this author in PubMed Google Scholar

  31. Kenji Wakai
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

the Japan Multi-institutional Collaborative Cohort (J-MICC) Study Group

  • Kenji Wakai
  • , Kenji Takeuchi
  • , Hiroki Nagase
  • , Haruo Mikami
  • , Hiroto Narimatsu
  • , Kiyonori Kuriki
  • , Sadao Suzuki
  • , Keitaro Matsuo
  • , Asahi Hishida
  • , Yoshikuni Kita
  • , Katsuyuki Miura
  • , Teruhide Koyama
  • , Kokichi Arisawa
  • , Hiroaki Ikezaki
  • , Keitaro Tanaka
  •  & Toshiro Takezaki

Corresponding author

Correspondence to Mizuki Ohashi.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Members of the Japan Multi-institutional Collaborative Cohort (J-MICC) Study Group are listed below the Acknowledgement Section.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ohashi, M., Miura, K., Takashima, N. et al. The association of reproductive history with hypertension and obesity according to menopausal status: the J-MICC Study. Hypertens Res 45, 708–714 (2022). https://doi.org/10.1038/s41440-021-00820-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41440-021-00820-0

Keywords

Search

Advanced search

Quick links