Abstract 17937: Higher Parity is Associated with Left Ventricular Diastolic Dysfunction: Echo Study of Latinos (Echo SOL)
Introduction: Previous literature indicates that having six or more pregnancies is associated with an increased risk of cardiovascular disease and that diastolic dysfunction (DD) may persist post-delivery. However, this relationship has not been studied in a Hispanic/Latina population despite higher parity (i.e., number of prior live births) observed amongst them. Our objective was to examine the relationship between parity and diastolic function in a population-based cohort. We hypothesized that higher parity would be associated with DD.
Methods: Participants included 855 Hispanic/Latina women, aged 45 and older, who were enrolled in the population-based Echocardiographic Study of Latinos (Echo-SOL) from four communities across the U.S. (Bronx, Miami, San Diego, and Chicago) and representative of several Hispanic backgrounds. Wake Forest School of Medicine served as the centralized reading center. Reproductive history was obtained by questionaire and DD was graded following an algorithm that combined ASE and Redfield criteria. Using sampling weights and survey statistics, multivariable logistic regression models assessed the relationship between parity and the presence of DD (grades I-III).
Results: In the target population, 4.7% were nulliparous (no live births) and 12.2% were grand multiparous (≥5 live births); 25% had diabetes, 42% had pre-diabetes and 27% were on anti-hypertensive medications. Among the nulliparous women, 51% had DD as compared to 61-63% of women with 2-4 live births and 85% of women with ≥5 live births (p = 0.03). In a multivariable model adjusted for age, body mass index, diabetes, systolic blood pressure and use of anti-hypertensive medications, the odds ratio for any grade of DD in grand-multiparous women compared to nulliparous women was 3.15 (95% CI 1.20-8.24, p<0.02). This association remained unchanged after further adjustment for smoking, total and high-density lipoprotein cholesterol.
Conclusions: Increasing number of live births is associated with the presence of DD among Hispanic/Latina women. Further studies are needed to determine the pathophysiology for the apparent deleterious consequences on diastolic function and whether these changes translate into heart failure with preserved ejection fraction.
Author Disclosures: S.R. Aggarwal: None. D.M. Herrington: None. C.J. Vladutiu: None. K. Swett: None. C.J. Rodriguez: None.
- © 2014 by American Heart Association, Inc.