Sex-Specific Epidemiology of Heart Failure Risk and Mortality in Europe Results From the BiomarCaRE Consortium
Sex-Specific Epidemiology of Heart Failure Risk and Mortality in Europe Results From the BiomarCaRE Consortium
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DOI：
10.1016/j.jchf.2018.08.008
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发表时间：
2019-03-01
影响因子：
13
通讯作者：
Schnabel, Renate B.
中科院分区：
文献类型：
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作者：
Magnussen, Christina;Niiranen, Teemu J.;Schnabel, Renate B.
目的研究心力衰竭(HF)风险和死亡率的性别差异。背景：心力衰竭流行病学中的性别差异尚不清楚。方法对78,657人(年龄中位数49.5岁；年龄范围24.1~98.7岁；51.7%的女性)进行基于社区的欧洲研究(FINRISK、DanMONICA、Moli-Sani，瑞典北部)，研究Biomarcare(欧洲心血管风险评估的生物标记物)联盟，心力衰竭发病率与死亡率之间的关系，心血管危险因素、常见心血管疾病、生物标记物(C-反应蛋白[CRP])的关系；结果在12.7年的中位随访期内，女性的心力衰竭病例(n=2,399例[5.9%])少于男性(n=2,771例[7.3%])。心力衰竭的发病率在60岁以后显著增加，最初在男性中增加得更快，而85岁以后女性的发病率高于男性。心力衰竭的发病大大增加了男女患者的死亡风险。多变量调整的COX模型显示以下性别差异：按SD计算的女性收缩压危险比(HR)为1.09(95%可信区间：1.05~1.14)，男性为1.19(95%CI：1.14~1.24)；心率危险比(HR)女性为0.98(95%CI：0.93~1.03)，男性为1.09(95%CI：1.04~1.13)；CRPHR女性为1.10(95%CI：1.00~1.20)，男性为1.32(95%CI：1.24~1.41)；NT-proBNP HR女性为1.54(95%CI：1.37~1.74)，男性为1.89(95%CI：1.75~2.05)。所有危险因素加在一起的人群归因危险度女性为59.0%，男性为62.9%。在收缩压、心率、C反应蛋白和NT-proBNP方面存在性别差异，女性发生心衰的风险较低。(C)2019年，由美国心脏病学会基金会主办。
OBJECTIVES This study investigates differences between women and men in heart failure (HF) risk and mortality.BACKGROUND Sex differences in HF epidemiology are insufficiently understood.METHODS In 78,657 individuals (median 49.5 years of age; age range 24.1 to 98.7 years; 51.7% women) from community-based European studies (FINRISK, DanMONICA, Moli-sani, Northern Sweden) of the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium, the association between incident HF and mortality, the relationship of cardiovascular risk factors, prevalent cardiovascular diseases, biomarkers (C-reactive protein [CRP]; N-terminal pro-B-type natriuretic peptide [NT-proBNP]) with incident HF, and their attributable risks were tested in women vs. men.RESULTS Over a median follow-up of 12.7 years, fewer HF cases were observed in women (n = 2,399 [5.9%]) than in men (n = 2,771 [7.3%]). HF incidence increased markedly after 60 years of age, initially with a more rapid increase in men, whereas incidence in women exceeded that of men after 85 years of age. HF onset substantially increased mortality risk in both sexes. Multivariable-adjusted Cox models showed the following sex differences for the association with incident HF: systolic blood pressure hazard ratio (HR) according to SD in women of 1.09 (95% confidence interval [CI]: 1.05 to 1.14) versus HR of 1.19 (95% CI: 1.14 to 1.24) in men; heart rate HR of 0.98 (95% CI: 0.93 to 1.03) in women versus HR of 1.09 (95% CI: 1.04 to 1.13) in men; CRP HR of 1.10 (95% CI: 1.00 to 1.20) in women versus HR of 1.32 (95% CI: 1.24 to 1.41) in men; and NT-proBNP HR of 1.54 (95% CI: 1.37 to 1.74) in women versus HR of 1.89 (95% CI: 1.75 to 2.05) in men. Population-attributable risk of all risk factors combined was 59.0% in women and 62.9% in men.CONCLUSIONS Women had a lower risk for HF than men. Sex differences were seen for systolic blood pressure, heart rate, CRP, and NT-proBNP, with a lower HF risk in women. (C) 2019 by the American College of Cardiology Foundation.