Risk Factor Burden, Heart Failure, and Survival in Women of Different Ethnic Groups
Final Accepted Manuscript
Foraker, Randi E.
Abraham, William T.
Whitfield, Keith E.
Manson, JoAnn E.
Eaton, Charles B.
Howard, Barbara V.
Cené, Crystal W.
Martin, Lisa W.
Johnson, Karen C.
AffiliationUniv Arizona, Sarver Heart Ctr, Div Cardiovasc Med
MetadataShow full item record
PublisherLIPPINCOTT WILLIAMS & WILKINS
CitationBreathett, K., Leng, I., Foraker, R. E., Abraham, W. T., Coker, L., Whitfield, K. E., ... & Ijioma, N. (2018). Risk Factor Burden, Heart Failure, and Survival in Women of Different Ethnic Groups: Insights From the Women’s Health Initiative. Circulation: Heart Failure, 11(5), e004642. https://doi.org/10.1161/CIRCHEARTFAILURE.117.004642
Rights© 2018 American Heart Association, Inc.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractBACKGROUND: The higher risk of heart failure (HF) in African-American and Hispanic women compared with white women is related to the higher burden of risk factors (RFs) in minorities. However, it is unclear if there are differences in the association between the number of RFs for HF and the risk of development of HF and death within racial/ethnic groups. METHODS AND RESULTS: In the WHI (Women's Health Initiative; 1993-2010), African-American (n=11 996), white (n=18 479), and Hispanic (n=5096) women with 1, 2, or 3+ baseline RFs were compared with women with 0 RF within their respective racial/ethnic groups to assess risk of developing HF or all-cause mortality before and after HF, using survival analyses. After adjusting for age, socioeconomic status, and hormone therapy, the subdistribution hazard ratio (95% confidence interval) of developing HF increased as number of RFs increased (P<0.0001, interaction of race/ethnicity and RF number P=0.18)African-Americans 1 RF: 1.80 (1.01-3.20), 2 RFs: 3.19 (1.84-5.54), 3+ RFs: 7.31 (4.26-12.56); Whites 1 RF: 1.27 (1.04-1.54), 2 RFs: 1.95 (1.60-2.36), 3+ RFs: 4.07 (3.36-4.93); Hispanics 1 RF: 1.72 (0.68-4.34), 2 RFs: 3.87 (1.60-9.37), 3+ RFs: 8.80 (3.62-21.42). Risk of death before developing HF increased with subsequent RFs (P<0.0001) but differed by racial/ethnic group (interaction P=0.001). The number of RFs was not associated with the risk of death after developing HF in any group (P=0.25; interaction P=0.48). CONCLUSIONS: Among diverse racial/ethnic groups, an increase in the number of baseline RFs was associated with higher risk of HF and death before HF but was not associated with death after HF. Early RF prevention may reduce the burden of HF across multiple racial/ethnic groups.
Note12 month embargo; published online: 1 May 2018
VersionFinal accepted manuscript
SponsorsNational Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services [HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, HHSN271201100004C]; National Institute of Health (NIH) [L60 MD010857]; University of Arizona Health Sciences, Strategic Priorities Faculty Initiative Grant