Epidemiology of Heart Failure in a Universal Healthcare system

我们对18至64岁的MHS受益人进行了一项横断面研究，以测量2018-19年HF分期的患病率，并评估性别，种族和其他社会人口学特征的差异。我们将HF分期定义为临床前HF（A或B期）或临床HF（C/D期）。临床HF由国际疾病分类，第十版，临床修改（ICD-10-CM）代码定义。 在6，375，086名18 - 64岁的MHS受益者中，临床前和临床HF的患病率非常高（18%和2.5%）。临床前HF患者主要为中年人，男性和女性比例相似。HF患者年龄稍大，主要是男性，从军队退役，入伍军衔（代表较低的社会经济地位）。男性、老年、黑人和低级别与临床前和临床HF的相对几率较高呈单变量相关。多变量校正后，男性、黑人和低级别与HF患病率的大幅增加独立相关。 所有阶段的HF在工作年龄的MHS受益人中非常普遍。临床前HF的高患病率在黑人受益人中尤其明显，这为预防提供了重要途径。在黑人受益人和社会经济地位较低的个人中，HF的巨大超额几率强调了进一步研究的迫切需要，以了解和解决这些差异的决定因素。 已发表摘要Roger VL，Banaag A，Korona-Bailey J，Turner C，Haigney MC，Koehlmoos TP.普遍投保的工作年龄人群的心力衰竭：军事社区经验。流通2022;145（Suppl_1）.

We conducted a cross-sectional study of MHS beneficiaries aged 18 to 64 years to measure the prevalence of HF stages in 2018-19 and evaluate disparities by sex, race, and other sociodemographic characteristics. We defined HF stages defined as preclinical HF (Stage A or B) or clinical HF (stages C/D). Clinical HF was defined by International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Among 6,375,086 MHS beneficiaries aged 18 to 64 years, the prevalence of both preclinical and clinical HF was remarkably high (18% and 2.5%). Persons with preclinical HF were mainly middle aged with similar proportions of men and women. Persons with HF were slightly older, mainly men, retired from military service, of enlisted rank (proxy for lower socio-economic status). Male sex, older age, black race, and lower rank were univariately associated with higher relative odds of both preclinical and clinical HF. After multivariable adjustment, male sex, black race and lower rank were independently associated with large increases in prevalent HF. All stages of HF are highly prevalent among MHS beneficiaries of working age. The high prevalence of preclinical HF particularly noticeable among Black beneficiaries delineates critical avenues for prevention. The large excess odds of HF among Black beneficiaries and among individuals with lower socio-economic status underscore the urgent need for further research to understand and address the determinants of these disparities. Published abstract Roger VL, Banaag A, Korona-Bailey J, Turner C, Haigney MC, Koehlmoos TP. Heart Failure In A Universally Insured Working Age Population: The Military Community Experience. Circulation. 2022;145(Suppl_1).