Rurality and Heart Failure: The Southern Community Cohort Study

调查结果摘要 在南方社区队列研究中，接受医疗保险或医疗补助服务的人口中，20%的参与者居住在农村地区。经过13年的中位数随访，年龄调整后的心力衰竭发病率城市为29.6/1,000人年，农村为36.5/1,000人年；P&lt；0.001。在调整了人口统计学、心血管危险因素、健康行为和社会经济状况后，农村参与者发生心力衰竭的风险比城市参与者高19%(HR 1.19，95%CI 1.13-1.26)。农村地区与心力衰竭相关的风险因种族性别而异，黑人男性的风险最大(风险比1.34，95%可信区间1.19-1.51)，其次是白人女性(风险比1.21，95%可信区间1.06-1.38)和黑人女性(风险比1.18，95%可信区间1.08-1.28)。在白人男性中，乡村生活与发生心力衰竭的风险并不相关(危险比0.97，95%可信区间0.81-1.15)。 我们发现，在美国东南部以低收入为主的个人中，乡村生活与女性和黑人男性心力衰竭风险的增加有关，在对心血管风险因素和社会经济地位进行调整后，这种风险仍然存在。 这种不平等表明需要进一步强调农村人口中的心力衰竭初级预防。 这些数据在2022年3月的美国心脏协会流行病学会议上以口头摘要的形式提交，并以摘要的形式发表：图雷卡莫·S，徐M，Joo J，Dixon D，Gupta DK，Lipworth L，Roger VL.南方社区队列研究中的农村与心力衰竭事件风险。发行量。2022；145(Suppl_1)。

Summary of findings Within the Southern Community cohort study population receiving services from Medicare or Medicaid, twenty percent of participants resided in rural areas. Over 13-years median follow-up, the age-adjusted HF incidence was 29.6/1,000 person years for urban and 36.5/1,000 person years for rural participants; p<0.001. After adjustment for demographics, CV risk factors, health behaviors, and SES, rural participants had a 19% greater risk of incident HF (HR 1.19, 95% CI 1.13-1.26) compared to their urban counterparts. The rurality associated risk of heart failure varied across race-sex groups and was greatest among Black men (Hazard ratio 1.34, 95% CI 1.19-1.51), followed by White women (Hazard ratio 1.21, 95% CI 1.06-1.38) and Black women (Hazard ratio 1.18, 95% CI 1.08-1.28). Among White men, rurality was not associated with greater risk of incident HF (Hazard ratio 0.97, 95% CI 0.81-1.15). We identified that among predominantly low-income individuals in the southeastern US, rurality was associated with an increased risk of HF among women and Black men, which persisted after adjustment for cardiovascular risk factors and socio-economic status. This inequity points to a need for additional emphasis on primary prevention of HF among rural populations. This data was presented as an oral abstract at the American Heart Association Epidemiology Meeting in March 2022 and published as an abstract: Turecamo S, Xu M, Joo J, Dixon D, Gupta DK, Lipworth L, Roger VL. Rurality and Incident Heart Failure Risk in The Southern Community Cohort Study. Circulation. 2022;145(Suppl_1).