Epidemiology of Heart Failure in a Universal Healthcare system

我们对18岁至岁的MHS受益人进行了一项横断面研究，以衡量2018-19年心力衰竭阶段的患病率，并评估性别、种族和其他社会人口学特征的差异。我们将心衰定义为临床前心衰(A期或B期)或临床心衰(C/D期)。临床心衰由国际疾病分类第十版临床修改(ICD-10-CM)编码定义。 在6,375,086名18岁至岁的MHS受益人中，临床前和临床心力衰竭的患病率都非常高(18%和2.5%)。临床前心力衰竭患者以中年为主，男女比例相近。患有心力衰竭的人年龄稍大，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、年龄较大、黑人和较低等级与临床前和临床心衰的相对风险较高是单变量相关的。经多因素调整后，男性、黑人和低级别与心力衰竭患病率的显著上升独立相关。 所有阶段的心衰在劳动年龄的卫生部受益者中都非常普遍。临床前心力衰竭的高流行率在黑人受益人中尤其明显，这勾勒出了预防的关键途径。黑人受益人和社会经济地位较低的个人罹患心力衰竭的几率很大，这突出表明迫切需要进行进一步研究，以了解和解决这些差距的决定因素。 发表摘要：Roger VL，Banaag A，Korona-Bailey J，Turner C，Haigney MC，Koehlmoos TP。全民参保劳动年龄人群中的心力衰竭：军人社区的经验。发行量。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).