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Risk Factors for Heart Failure: 20-Year Population-Based Trends by Sex, Socioeconomic Status, and Ethnicity.

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posted on 2020-05-11, 15:18 authored by Claire A Lawson, Francesco Zaccardi, Iain Squire, Hajra Okhai, Melanie Davies, Weiting Huang, Mamas Mamas, Carolyn SP Lam, Kamlesh Khunti, Umesh T Kadam
BACKGROUND:There are multiple risk factors for heart failure, but contemporary temporal trends according to sex, socioeconomic status, and ethnicity are unknown. METHODS:Using a national UK general practice database linked to hospitalizations (1998-2017), 108 638 incident heart failure patients were identified. Differences in risk factors among patient groups adjusted for sociodemographic factors and age-adjusted temporal trends were investigated using logistic and linear regression. RESULTS:Over time, a 5.3 year (95% CI, 5.2-5.5) age difference between men and women remained. Women had higher blood pressure, body mass index, and cholesterol than men (P<0.0001). Ischemic heart disease prevalence increased for all to 2006 before reducing in women by 0.5% per annum, reaching 42.7% (95% CI, 41.7-43.6), but not in men, remaining at 57.7% (95% CI, 56.9-58.6; interaction P=0.002). Diabetes mellitus prevalence increased more in men than in women (interaction P<0.0001). Age between the most deprived (74.6 years [95% CI, 74.1-75.1]) and most affluent (79.9 [95% CI, 79.6-80.2]) diverged (interaction P<0.0001), generating a 5-year gap. The most deprived had significantly higher annual increases in comorbidity numbers (+0.14 versus +0.11), body mass index (+0.14 versus +0.11 kg/m2), and lower smoking reductions (-1.2% versus -1.7%) than the most affluent. Ethnicity trend differences were insignificant, but South Asians were overall 6 years and the black group 9 years younger than whites. South Asians had more ischemic heart disease (+16.5% [95% CI, 14.3-18.6]), hypertension (+12.5% [95% CI, 10.5-14.3]), and diabetes mellitus (+24.3% [95% CI, 22.0-26.6]), and the black group had more hypertension (+12.3% [95% CI, 9.7-14.8]) and diabetes mellitus (+13.1% [95% CI, 10.1-16.0]) but lower ischemic heart disease (-10.6% [95% CI, -13.6 to -7.6]) than the white group. CONCLUSIONS:Population groups show distinct risk factor trend differences, indicating the need for contemporary tailored prevention programs.

Funding

This research was supported by Leicester-Wellcome Trust Institutional Strategic Support Fund Fellowship (Reference 204801/Z/16/Z) and National Institute of Health Research (NIHR) Leicester Biomedical Research Centre. Dr Zaccardi is funded with an unrestricted educational grant from the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East Midlands to the University of Leicester. The views and opinions expressed here are those of the authors and do not necessarily reflect those of the Wellcome Trust or NIHR.

History

Citation

Circulation: Heart Failure. 2020;13:e006472

Version

  • VoR (Version of Record)

Published in

Circulation. Heart failure

Volume

13

Issue

2

Pagination

e006472

Publisher

Ovid Technologies (Wolters Kluwer Health)

issn

1941-3289

eissn

1941-3297

Acceptance date

2019-12-19

Copyright date

2020

Available date

2020-02-14

Publisher version

https://www.ahajournals.org/doi/full/10.1161/CIRCHEARTFAILURE.119.006472

Spatial coverage

UK

Language

eng

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