Claire A Lawson1, Francesco Zaccardi1, Iain Squire2, Hajra Okhai1, Melanie Davies1, Weiting Huang3, Mamas Mamas4, Carolyn S P Lam3,5,6, Kamlesh Khunti1, Umesh T Kadam1,7. 1. Diabetes Research Centre (C.A.L., F.Z., H.O., M.D., K.K., U.T.K.), University of Leicester, United Kingdom. 2. Cardiovascular Research Centre, Glenfield General Hospital (I.S.), University of Leicester, United Kingdom. 3. National Heart Centre, Duke-NUS Medical School, Singapore (H.W., C.S.P.L.). 4. Keele Cardiovascular Group, Keele University, United Kingdom (M.M.). 5. University Medical Centre Groningen, the Netherlands (C.S.P.L.). 6. The George Institute for Global Health, Newton, NSW, Australia (C.S.P.L.). 7. Department of Health Sciences (U.T.K.), University of Leicester, United Kingdom.
Abstract
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.
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 failurepatients 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.
Authors: Arjun Sinha; Avni Bavishi; Elizabeth A Hibler; Eric H Yang; Susmita Parashar; Tochukwu Okwuosa; Jeanne M DeCara; Sherry-Ann Brown; Avirup Guha; Diego Sadler; Sadiya S Khan; Sanjiv J Shah; Clyde W Yancy; Nausheen Akhter Journal: Front Cardiovasc Med Date: 2022-05-20
Authors: Matthew T Mefford; Michael J Silverberg; Thomas K Leong; Rulin C Hechter; William J Towner; Alan S Go; Michael Horberg; Haihong Hu; Teresa N Harrison; Sue Hee Sung; Kristi Reynolds Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2022-05-03