 |
|
Epidemiology of Incident Heart Failure in a Contemporary Elderly CohortThe Health, Aging, and Body Composition Study
Andreas Kalogeropoulos, MD;
Vasiliki Georgiopoulou, MD;
Stephen B. Kritchevsky, PhD;
Bruce M. Psaty, MD, PhD;
Nicholas L. Smith, PhD, MPH;
Anne B. Newman, MD, MPH;
Nicolas Rodondi, MD, MS;
Suzanne Satterfield, MD, DrPH;
Douglas C. Bauer, MD;
Kirsten Bibbins-Domingo, PhD, MD;
Andrew L. Smith, MD;
Peter W. F. Wilson, MD;
Ramachandran S. Vasan, MD, DM;
Tamara B. Harris, MD, MS;
Javed Butler, MD, MPH
Arch Intern Med. 2009;169(7):708-715.
Background The race- and sex-specific epidemiology of incident heart failure (HF) among a contemporary elderly cohort are not well described.
Methods We studied 2934 participants without HF enrolled in the Health, Aging, and Body Composition Study (mean [SD] age, 73.6 [2.9] years; 47.9% men; 58.6% white; and 41.4% black) and assessed the incidence of HF, population-attributable risk (PAR) of independent risk factors for HF, and outcomes of incident HF.
Results During a median follow-up of 7.1 years, 258 participants (8.8%) developed HF (13.6 cases per 1000 person-years; 95% confidence interval, 12.1-15.4). Men and black participants were more likely to develop HF. No significant sex-based differences were observed in risk factors. Coronary heart disease (PAR, 23.9% for white participants and 29.5% for black participants) and uncontrolled blood pressure (PAR, 21.3% for white participants and 30.1% for black participants) carried the highest PAR in both races. Among black participants, 6 of 8 risk factors assessed (smoking, increased heart rate, coronary heart disease, left ventricular hypertrophy, uncontrolled blood pressure, and reduced glomerular filtration rate) had more than 5% higher PAR compared with that among white participants, leading to a higher overall proportion of HF attributable to modifiable risk factors in black participants vs white participants (67.8% vs 48.9%). Participants who developed HF had higher annual mortality (18.0% vs 2.7%). No racial difference in survival after HF was noted; however, rehospitalization rates were higher among black participants (62.1 vs 30.3 hospitalizations per 100 person-years, P < .001).
Conclusions Incident HF is common in older persons; a large proportion of HF risk is attributed to modifiable risk factors. Racial differences in risk factors for HF and in hospitalization rates after HF need to be considered in prevention and treatment efforts.
Author Affiliations: Departments of Medicine, Emory University, Atlanta, Georgia (Drs Kalogeropoulos, Georgiopoulou, A. L. Smith, Wilson, and Butler); and Wake Forest University, Winston-Salem, North Carolina (Dr Kritchevsky); Departments of Medicine (Dr Psaty) and Epidemiology (Dr N. L. Smith), University of Washington, and Seattle VA Epidemiologic Research and Information Center, VA Puget Sound Health Care System (Dr N. L. Smith), Seattle, Washington; Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Newman); Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland (Dr Rodondi); Department of Preventive Medicine, University of Memphis, Memphis, Tennessee (Dr Satterfield); Department of Medicine, University of California, San Francisco (Drs Bauer and Bibbins-Domingo); Department of Medicine, Boston University, Boston, Massachusetts (Dr Vasan); and Geriatrics Epidemiology Section, National Institute on Aging, National Institutes of Health, Bethesda, Maryland (Dr Harris).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLE
In This Issue of Archives of Internal Medicine
Arch Intern Med. 2009;169(7):648.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Heart failure burden and therapy
Zannad et al.
Europace 2009;11:v1-v9.
ABSTRACT
| FULL TEXT
Heart Failure in an Aging Population
Journal Watch Cardiology 2009;2009:2-2.
FULL TEXT
|
