Background: Diastolic dysfunction (DD) is closely linked to the progression of heart failure (HF).It remains unknown what factors contribute to the onset of DD.Method: This study included randomly selected women,age＞45 years, who had ＞2 echocardiography between 2009 and 2012.Patients were excluded if they had a prior HF diagnosis or echocardiographic evidence of DD.Mild DD was defined as: LVE.F ＞50％, E./A ratio ＜0.75 and E/es8.