Abstract P411: Does Age at Natural Menopause Influence Changes in Left Ventricular Structure and Function During the Menopausal Transition? The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Abstract

Introduction: The association between menopause and incident cardiovascular disease (CVD) is controversial. Cardiac structure and function are important predictors of future CVD events, however, evidence for the long-term association of age at natural menopause (NM) with cardiac remodeling as women transition through menopause is lacking. We assessed the hypothesis that age at NM will be positively associated with changes in echocardiographic parameters of left ventricular (LV) structure and function. Methods: We studied 771 premenopausal women (37% black) from the Coronary Artery Risk Development in Young Adults (CARDIA) Study with echocardiographic data in 1990-1991 (mean age: 32 years) who later reached NM by 2015-2016 and had additional echocardiogram. Results: Mean age at NM was 50 years and the average time from menopause to the last echocardiogram was 7 years. In cross-sectional analyses, no associations were found between age at NM and premenopausal baseline parameters of LV structure and function (Table1). However, a one-year decrement in age at NM was significantly associated with higher postmenopausal levels of LV mass (LVM), LVM indexed to body surface area, LV mass-to-volume ratio, and relative wall thickness. In longitudinal analyses, higher age at NM was inversely associated with pre-to-postmenopausal changes in LV structure parameters. Controlling for baseline echocardiographic parameters, demographics, smoking, systolic blood pressure, BMI, physical activity, reproductive factors, total cholesterol and pre- to postmenopausal changes in systolic blood pressure, BMI and total cholesterol as well as hormone therapy attenuated the association of age at NM with these LV structure parameters. Conclusion: In this study, premenopausal CVD risk factors explained the association of age at NM with changes in LV structure parameters during the menopausal transition. These data suggest that premenopausal CVD risk factors rather than age at NM may predispose women to elevated future CVD risk.