Abstract 10384: Age at Menopause and Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis
Objective: To evaluate associations of early menopause (menopause occurring before 45 years of age) and age at menopause with incident heart failure (HF) in post-menopausal women. We also explored associations of early, and age at menopause with left ventricular (LV) measures of structure and function in post-menopausal women.
Methods: We included 2947 post-menopausal women, aged 45-84 years, without known cardiovascular disease (2000-2002), from the Multi-Ethnic study of Atherosclerosis. Cox-Proportional hazards models were used to examine associations of early, and age at menopause with incident HF. In 2123 post-menopausal women in whom cardiac magnetic resonance imaging was obtained at baseline, we explored associations of early, and age at menopause with LV measures using multivariable linear regression.
Results: The mean age of participants was 64.7 years, 24.8% experienced early menopause, 38.0% were Caucasians, 11.7% were Chinese-Americans, 28.5% were African-Americans and 21.8% were Hispanics. Over a median follow-up of 8.5 years, we observed 71 HF events. There were no interactions with ethnicity for incident HF. In adjusted analysis, early menopause was associated with increased risk of incident HF [1.81 (1.03-3.19)], while each year increase in age at menopause was associated with decreased risk of incident HF [0.96 (0.93-0.99)]. We observed significant interactions between early menopause and ethnicity for LV mass to volume ratio (LVMVR), Pinteraction=0.02. In Chinese-American women, early menopause was associated with higher LVMVR (+0.11, p=0.0002), while each year increase in age at menopause was associated with lower LVMVR (-0.004, p=0.04) at baseline.
Conclusion: An older menopausal age is independently associated with decreased risk of incident HF. Concentric LV remodelling, indicated by a higher LVMVR was present in Chinese-Americans with early menopause at baseline.
- © 2013 by American Heart Association, Inc.