Abstract 12555: Biomass Fuel Use and Cardiac Function in Nepali Women

• Published in: Circulation (New York, N.Y.) Vol. 140; no. Suppl_1 Suppl 1; p. A12555
• Main Authors: Benziger, Catherine P, Tiwana, Jasleen, Hooper, Laura, Pope, Karl, Alurkar, Vijay, Kafle, Ramchandra, Sijali, Tula R, Balmes, John, Kaufman, Joel, Bates, Michael
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 19.11.2019
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.12555

IntroductionExposure to household air pollution (HAP) from cooking with biomass fuel potentially affects billions of people worldwide.HypothesisHAP from wood smoke compared to other household fuels was associated with adverse cardiovascular outcomes.MethodsA cross-sectional study was completed in 299 females aged 40-70 years (mean 53.8 years) in Kaski District, Nepal, during 2017-18. All participants underwent a standard 12-lead ECG, ankle and brachial systolic blood pressure measurement, and 2D color and Doppler echocardiography. Current stove type was confirmed by inspection. Blood pressure, height and weight were measured using a standardized protocol. Hypertension was defined as greater than or equal to 140/90 mmHg or prior diagnosis. Hemoglobin A1c (HbA1c) was obtained, with diabetes mellitus defined as a prior diagnosis or HbA1C greater than or equal to 6.5%. We used adjusted linear and logistic multivariable regressions to examine the relationship of stove type with cardiac structure and function.ResultsThe primary stove type used by the majority of women was liquified petroleum gas (LPG) stoves (65%), while 12% used biogas and 23% wood-burning cook-stoves. The prevalence of cardiovascular risk factors was35% with hypertension, 19% with diabetes mellitus, and 15% were current smokers. After adjustment, compared to those using LPG stoves, use of wood stoves was associated with increased indexed left atrial volume (β=3.15, 95% CI 1.22 to 5.09), increased indexed left ventricular end diastolic volume (β=7.97, 95% CI 3.11 to 12.83). There was no association between stove type and systemic hypertension, left ventricular mass, systolic dysfunction, diastolic dysfunction, pulmonary hypertension, abnormal ankle-brachial index or clinically significant ECG abnormalities.ConclusionsBiomass fuel use was associated with increased indexed left atrial volume and increased indexed left ventricular diastolic volume, suggesting subclinical adverse cardiac remodeling from HAP in this cross-sectional study of Nepali women. We did not find evidence of an association with hypertension or typical cardiac sequelae of hypertension. Future studies to confirm these results are needed.