Trends in Heart Failure Incidence and Survival in a Community-Based Population

Roger, Véronique L.; Weston, Susan A.; Redfield, Margaret M.; Hellermann-Homan, Jens P.; Killian, Jill M.; Yawn, Barbara P.; Jacobsen, Steven J.

doi:10.1001/jama.292.3.344

Cited by 1,396 publications

(736 citation statements)

References 31 publications

(27 reference statements)

Supporting

Mentioning

684

Contrasting

Unclassified

Order By: Relevance

“…Consistent with previous studies, the 5‐year mortality rate following HF diagnosis was ≈50% in HRS participants1, 35, 36 and whites had generally lower survival rates than nonwhites (Figure S3). 1, 2, 7, 10 …”

Section: Methodssupporting

confidence: 89%

Racial and Ethnic Differences in Trajectories of Hospitalization in US Men and Women With Heart Failure

Dupre

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundPrior studies have documented racial and ethnic disparities in hospitalization among patients with heart failure (HF). However, racial/ethnic differences in trajectories of hospitalization following the diagnosis of HF have not been well characterized. This study examined racial/ethnic differences in individual‐level trajectories of hospitalization in older adults with diagnosed HF.Methods and ResultsData from a nationally representative prospective cohort of US men and women aged 45 years and older were used to examine the number of hospitalizations reported every 24 months. Participants who were non‐Hispanic white, non‐Hispanic black, and Hispanic with a reported diagnosis of HF (n=3011) were followed from 1998 to 2014. Results showed a quadratic change in the number of reported hospitalizations following HF diagnosis, with an average of 2.36 (95% confidence interval [CI], 2.19–2.53; P<0.001) hospitalizations within 24 months that decreased by 0.35 (95% CI, −0.45 to −0.25; P<0.001) every 24 months and subsequently increased by 0.03 (95% CI, 0.02–0.05; P<0.001) thereafter. In men, there were no racial/ethnic differences in hospitalizations reported at the time of diagnosis; however, Hispanic men had significant declines in hospitalizations after diagnosis (Hispanic×time=−0.52; 95% CI, −0.99 to −0.05 [P=0.031]) followed by a sizeable increase in hospitalizations at later stages of disease (Hispanic×time2=0.06; 95% CI, 0.00–0.12 [P=0.047]). In women, hospitalizations were consistently high following their diagnosis and black women had significantly more hospitalizations throughout follow‐up than white women (black=0.28; 95% CI, 0.00–0.55 [P=0.048]). Racial/ethnic disparities varied by geography and the differences remained significant after adjusting for multiple sociodemographic, psychosocial, behavioral, and physiological factors.ConclusionsThere were significant racial/ethnic differences in trajectories of hospitalization following the diagnosis of HF in US men and women. Racial/ethnic disparities varied by place of residence and the differences persisted after adjustment for multiple risk factors. The findings have important implications that may be crucial to planning the immediate and long‐term delivery of care in patients with HF to reduce potentially preventable hospitalizations.

show abstract

Section: Methodssupporting

confidence: 89%

Racial and Ethnic Differences in Trajectories of Hospitalization in US Men and Women With Heart Failure

Dupre

et al. 2017

JAHA

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…People with HF often experience a reduction in quality of life, higher mortality rates, and increased risk for other CVD events 31, 32, 33, 34. More than half of the people diagnosed with HF will die within 5 years 32, 33. An estimated 870 000 new cases of HF are documented in the United States annually, and, if the current trend continues, it is projected that by 2030 over 8 million people, aged 18 years or older, will have the disease 5.…”

Section: Discussionmentioning

confidence: 99%

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Ogunmoroti

Oni

Michos

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundThe American Heart Association introduced the Life's Simple 7 (LS7) metrics to assess and promote cardiovascular health. We sought to examine the association between the LS7 metrics and incident heart failure (HF) in a multiethnic cohort.Methods and ResultsWe analyzed data from 6506 participants of the Multi‐Ethnic Study of Atherosclerosis free of cardiovascular disease at baseline. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol, and blood glucose) were graded on a scale of 0 to 2, with 2 indicating “ideal” status, 1 “intermediate” status, and 0 “poor” status. Points were summed, thus the LS7 score ranged from 0 to 14. Cox proportional hazard ratios and incidence rates of HF per 1000 person‐years were calculated. During a median follow‐up of 12.2 years, 262 (4%) participants developed HF. Incidence of HF decreased as the number of ideal LS7 metrics increased; 5.9 per 1000 person‐years for participants with 0 to 1 ideal metrics and 0.6 per 1000 person‐years for those with 6 to 7 ideal metrics. Compared with inadequate scores (0–8 points), hazard ratios for HF were 0.57 (0.43–0.76) and 0.31 (0.19–0.49) for average (9–10 points) and optimal (11–14 points) scores, respectively. A similar pattern was observed when the results were stratified by 4 racial/ethnic groups: white, Chinese American, black, and Hispanic.ConclusionsA lower risk of HF with more favorable LS7 status regardless of race/ethnicity suggests that efforts to achieve ideal cardiovascular health may reduce the burden of HF, a major source of morbidity and mortality.

show abstract

“…Heart failure is one of the most common causes of hospitalization and death, with an increasing trend in the number of patients living with heart failure 1. It has been acknowledged that several comorbid conditions and biomarkers are associated with disease progression and outcome in heart failure 2.…”

Section: Introductionmentioning

confidence: 99%

Subclinical hypothyroidism is an independent predictor of adverse cardiovascular outcomes in patients with acute decompensated heart failure

et al. 2016

View full text Add to dashboard Cite

AimsAltered thyroid hormone metabolism characterized by a low triiodothyronine (T3), so‐called low‐T3 syndrome, is a common finding in patients with severe systemic diseases. Additionally, subclinical thyroid dysfunction, defined as abnormal thyroid stimulating hormone (TSH) and normal thyroxine (T4), causes left ventricular dysfunction. Our objective was to identify the prevalence and prognostic impact of low‐T3 syndrome and subclinical thyroid dysfunction in patients with acute decompensated heart failure (ADHF).Methods and resultsWe examined 274 ADHF patients who were not receiving thyroid medication or amiodarone on admission (70 ± 15 years, 156 male), who underwent thyroid function tests. Euthyroidism was defined as TSH of 0.45 to 4.49 mIU/L; subclinical hypothyroidism as TSH of 4.5 to 19.9 mIU/L; and subclinical hyperthyroidism as TSH < 0.45 mIU/L, with normal free T4 level for the last two. Additionally, low‐T3 syndrome was defined as free T3 < 4.0 pmol/L among euthyroidism subjects. On admission, 188 patients (69%) showed euthyroidism, 58 (21%) subclinical hypothyroidism, 5 (2%) subclinical hyperthyroidism, and 95 (35%) low‐T3 syndrome. Cox proportional hazards models revealed that higher TSH, but not free T3 and free T4, was independently associated with composite cardiovascular events, including cardiac death and re‐hospitalization for heart failure. Indeed, subclinical hypothyroidism was an independent predictor (hazard ratio: 2.31; 95% confidence interval: 1.44 to 3.67; P < 0.001), whereas low‐T3 syndrome and subclinical hyperthyroidism were not.ConclusionsSubclinical hypothyroidism on admission was an independent predictor of adverse cardiovascular outcomes in ADHF patients, suggesting a possible interaction between thyroid dysfunction and the pathophysiology of ADHF.

show abstract

Trends in Heart Failure Incidence and Survival in a Community-Based Population

Cited by 1,396 publications

References 31 publications

Racial and Ethnic Differences in Trajectories of Hospitalization in US Men and Women With Heart Failure

Racial and Ethnic Differences in Trajectories of Hospitalization in US Men and Women With Heart Failure

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Subclinical hypothyroidism is an independent predictor of adverse cardiovascular outcomes in patients with acute decompensated heart failure

Contact Info

Product

Resources

About