Epidemiology of incident heart failure in a contemporary elderly cohort: the health, aging, and body composition study.
Epidemiology of incident heart failure in a contemporary elderly cohort: the health, aging, and body composition study.
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DOI：
10.1001/archinternmed.2009.40
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发表时间：
2009-04-13
影响因子：
--
通讯作者：
Butler, Javed
中科院分区：
文献类型：
--
作者：
Kalogeropoulos, Andreas;Georgiopoulou, Vasiliki;Kritchevsky, Stephen B.;Psaty, Bruce M.;Smith, Nicholas L.;Newman, Anne B.;Rodondi, Nicolas;Satterfield, Suzanne;Bauer, Douglas C.;Bibbins-Domingo, Kirsten;Smith, Andrew L.;Wilson, Peter W. F.;Vasan, Ramachandran S.;Harris, Tamara B.;Butler, Javed
在当代老年人群中，心力衰竭（HF）的种族和性别特异性流行病学还没有得到很好的描述。我们研究了2934例健康ABC研究中未发生HF的受试者（年龄73.6±2.9岁，47.9%为男性，58.6%为白色，41.4%为黑人），并评估了HF的发病率、HF独立危险因素的人群归因风险（PAR）和HF事件的结局。在中位随访7.1年期间，258例（8.8%）参与者发生HF（13.6/1000人-年）。男性和黑人更有可能发展为HF。在危险因素方面没有观察到显着的性别差异。冠心病（白人：PAR 23.9%，黑人：PAR 29.5%）和未控制的血压（白人：PAR 21.3%，黑人：PAR 30.1%）在两个种族中的PAR最高。在黑人中，评估的8个风险因素中有6个（冠心病、血压不受控制、左心室肥大、肾小球滤过率降低、吸烟和心率增加）的PAR比白人高5%以上，导致黑人中可归因于可改变风险因素的HF总比例高于白人（67.8% vs. 48.9%）。发生HF的参与者的年死亡率较高（18.0% vs. 2.7%）。HF后的生存率没有种族差异;然而，黑人的再住院率更高（62.1对30.3/100人-年，P<0.001）。HF事件在老年人中很常见;很大一部分HF风险归因于可改变的风险因素。HF危险因素和HF后住院率的种族差异需要考虑预防和治疗工作。
Race- and gender- specific epidemiology of incident heart failure (HF) in a contemporary elderly cohort is not well described. We studied 2934 participants without HF enrolled in the Health ABC Study (age 73.6±2.9 years, 47.9% men, 58.6% white, 41.4% black) and assessed incidence of HF, population attributable risk (PAR) of independent risk factors for HF, and outcomes of incident HF. During a median follow-up of 7.1 years, 258 (8.8%) participants developed HF (13.6/1000 person-years). Men and blacks were more likely to develop HF. No significant sex-based differences were observed in risk factors. Coronary heart disease (whites: PAR 23.9%, blacks: PAR 29.5%) and uncontrolled blood pressure (whites: PAR 21.3%, blacks: PAR 30.1%) carried the highest PAR in both races. In blacks, 6 out of 8 risk factors assessed (coronary heart disease, uncontrolled blood pressure, left ventricular hypertrophy, reduced glomerular filtration rate, smoking, and increased heart rate) had >5% higher PAR compared to whites, leading to a higher overall proportion of HF attributable to modifiable risk factors in blacks vs. whites (67.8% vs. 48.9%). Participants who developed HF had a higher annual mortality (18.0% vs. 2.7%). No racial difference in survival after HF was noted; however, rehospitalization rates were higher in blacks (62.1 vs. 30.3/100 person-years, P<.001). Incident HF is common in the elderly; a large proportion of HF risk was attributed to modifiable risk factors. Racial differences in risk factors for HF and in hospitalization rates after HF need to be accounted for prevention and treatment efforts.
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