Abstract 11033: Association of Albuminuria With Cardiac Dysfunction in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Echocardiographic Study of Latinos (Echo-SOL) Ancillary Study

Abstract

Introduction: Higher urinary albumin has been associated with cardiac dysfunction in the general population. The generalizability of these findings to Hispanics/Latinos, a group in which ethnic CVD disparities have been documented, is unknown. Methods: Echo-SOL is an ancillary study of the HCHS/SOL, a population-based study of Hispanics/Latinos across 4 US sites. Echo-SOL participants underwent standard echocardiography. Urine albumin-to-creatinine ratio (UACR) was used to assess albuminuria and categorized as normal and high normal (based on the midpoint of values below microalbuminuria), microalbuminuria (≥17 mg/g for men; ≥25 for women), and macroalbuminuria (≥250; ≥355). Outcomes included left ventricular (LV) hypertrophy (using standard sex-specific cutpoints for LV mass index), LV systolic dysfunction (EF<50%), and any LV diastolic dysfunction. We assessed the association of UACR with cardiac dysfunction, adjusting for demographics (sex, age, Hispanic/Latino background) and cardiometabolic factors. Results: The study sample consisted of 1,525 participants (median age 54, female 65%, median BMI 29, diabetes 27%). Overall, 43% had normal UACR, 43% high normal UACR, 12% microalbuminuria, and 2% macroalbuminuria. The prevalence of LV hypertrophy was 13%, LV systolic dysfunction 3%, and diastolic dysfunction 59%. After adjustment, both micro- and macroalbuminuria were significantly associated with LV hypertrophy but not LV systolic dysfunction (Table). Increasing levels of albuminuria, even at high normal levels, were significantly associated with greater diastolic dysfunction. Conclusions: Higher UACR was associated with LV hypertrophy and diastolic dysfunction in the largest known population sample of US Hispanic/Latinos. These findings suggest that screening and detection of even high normal UACR could be of value to guide CVD prevention efforts among Hispanic Americans, who may represent an especially vulnerable population.