Disparities and drivers of early age at diagnosis of congestive heart failure in the USA

Ditah, Chobufo; Rahman, Ebad Ur; Agbor, Valirie Ndip; Foryoung, Joyce Bei; Shahzad, Moazzam; Amgai, Birendra; Kafle, Paritosh; Jonnadula, Saikiran; Nfor, Tonga; Dufresne, Alix

doi:10.1016/j.ijcard.2019.06.001

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…Heart failure (HF) affects about 6.5million persons in the USA, constituting a major public health problem [1,2]. Patients with HF suffer reduced functional capacity, poorer quality of life and decreased survival.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and association of iron deficiency with anemia among patients with heart failure in the USA: NHANES 2017-2018

Chobufo

Rahman

Gayam

et al. 2021

Journal of Community Hospital Internal Medicine Perspectives

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Background: Heart failure (HF) is a major debilitating disease. HF patients with iron deficiency(ID) have poorer outcomes and treatment significantly improves outcomes. We set out to update the national prevalence of ID in the USA and its association with anemia using data from NHANES 2017-2018. Methods: Diagnosis of HF was self-reported. ID was defined as serum ferritin levels <100 ng/ mL or a ferritin level between 100 and 299 ng/mL with transferrin saturation <20%. Anemia was defined as a hemoglobin level of <13 g/dl and <12 g/dl for men and women, respectively. Differences in prevalence of ID across various groups were assessed using Chi-squared test for categorical variables and equality of means for continuous variables with p-values <0.05 considered statistically significant. Results: A total of 187 persons ≥20 years, corresponding to a 5.57million had HF. The prevalence of ID was 48.17% (95% CI 36.84-59.69) and the prevalence of anemia was 12.08%(95% CI 8.16-17.53). Diabetics (61.03%) were more likely to have ID compared to nondiabetics (35.38%), p 0.022. The prevalence of ID was similar in persons with anemia (47.45%) and persons without anemia (48.27%), p-value 0.983. The prevalence of ID has been constant for at least the past 20 years, making ID in HF an underdiagnose and/or undertreated condition among patients with HF and should be addressed. Conclusions: One in every two persons with HF has ID. Also, prevalence of ID was similar in patients with anemia and without anemia. Anemia should not be considered a prerequisite for screening for ID in patients with HF.

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Section: Introductionmentioning

confidence: 99%

Prevalence and association of iron deficiency with anemia among patients with heart failure in the USA: NHANES 2017-2018

Chobufo

Rahman

Gayam

et al. 2021

Journal of Community Hospital Internal Medicine Perspectives

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“…[2][3][4] In fact, individuals living below the poverty line have been shown to develop HF more than 5 years earlier than those living above the poverty line. 5 While the effects of multiple individual-level socioeconomic factors-including educational attainment and employment status in addition to personal income-have been emphasized in HF research, there is mounting evidence that neighborhoodlevel factors may also drive a proportion of HF risk. 4,[6][7][8][9][10] Prior analyses have demonstrated robust associations between neighborhood poverty and key HF risk factors, suggesting the existence of "a place-based health disadvantage".…”

Section: Introductionmentioning

confidence: 99%

Neighborhood Poverty and Incident Heart Failure: an Analysis of Electronic Health Records from 2005 to 2018

et al. 2021

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BACKGROUND: Neighborhood-level characteristics, such as poverty, have been associated with risk factors for heart failure (HF), including hypertension and diabetes mellitus. However, the independent association between neighborhood poverty and incident HF remains understudied. OBJECTIVE: To evaluate the association between neighborhood poverty and incident HF using a "real-world" clinical cohort. DESIGN: Retrospective cohort study of electronic health records from a large healthcare network. Individuals' residential addresses were geocoded at the census-tract level and categorized by poverty tertiles based on American Community Survey data (2007)(2008)(2009)(2010)(2011). PARTICIPANTS: Patients from Northwestern Medicine who were 30-80 years, free of cardiovascular disease at index visit (January 1, 2005-December 1, 2013), and followed for at least 5 years. MAIN MEASURES:The association of neighborhood-level poverty tertile (low, intermediate, and high) and incident HF was analyzed using generalized linear mixed effect models adjusting for demographics (age, sex, race/ethnicity) and HF risk factors (body mass index, diabetes mellitus, hypertension, smoking status). KEY RESULTS: Of 28,858 patients included, 75% were non-Hispanic (NH) White, 43% were men, 15% lived in a high-poverty neighborhood, and 522 (1.8%) were diagnosed with incident HF. High-poverty neighborhoods were associated with a 1.80 (1.35, 2.39) times higher risk of incident HF compared with low-poverty neighborhoods after adjustment for demographics and HF risk factors. CONCLUSIONS: In a large healthcare network, incident HF was associated with neighborhood poverty independent of demographic and clinical risk factors. Neighborhood-level interventions may be needed to complement individual-level strategies to prevent and curb the growing burden of HF.

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Targeting social disadvantage to prevent early development of heart failure

Emdin

Aimo

Poletti

et al. 2019

International Journal of Cardiology

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Disparities and drivers of early age at diagnosis of congestive heart failure in the USA

Cited by 4 publications

References 18 publications

Prevalence and association of iron deficiency with anemia among patients with heart failure in the USA: NHANES 2017-2018

Prevalence and association of iron deficiency with anemia among patients with heart failure in the USA: NHANES 2017-2018

Neighborhood Poverty and Incident Heart Failure: an Analysis of Electronic Health Records from 2005 to 2018

Targeting social disadvantage to prevent early development of heart failure

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