Risk Factor Burden, Heart Failure, and Survival in Women of Different Ethnic Groups: Insights From the Women's Health Initiative
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...
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| Veröffentlicht in: | Circulation. Heart failure 2018-05, Vol.11 (5), p.e004642-e004642 |
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| creator | Breathett, Khadijah Leng, Iris Foraker, Randi E Abraham, William T Coker, Laura Whitfield, Keith E Shumaker, Sally Manson, JoAnn E Eaton, Charles B Howard, Barbara V Ijioma, Nkechinyere Cené, Crystal W Martin, Lisa W Johnson, Karen C Klein, Liviu |
| description | 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.
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 ( |
| doi_str_mv | 10.1161/CIRCHEARTFAILURE.117.004642 |
| format | Article |
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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 (
<0.0001, interaction of race/ethnicity and RF number
=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 (
<0.0001) but differed by racial/ethnic group (interaction
=0.001). The number of RFs was not associated with the risk of death after developing HF in any group (
=0.25; interaction
=0.48).
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.</description><identifier>ISSN: 1941-3289</identifier><identifier>ISSN: 1941-3297</identifier><identifier>EISSN: 1941-3297</identifier><identifier>DOI: 10.1161/CIRCHEARTFAILURE.117.004642</identifier><identifier>PMID: 29716899</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Black or African American ; Ethnicity ; Female ; Heart Failure - mortality ; Humans ; Middle Aged ; Proportional Hazards Models ; Racial Groups ; Risk Factors ; Survival Analysis ; Women's Health</subject><ispartof>Circulation. Heart failure, 2018-05, Vol.11 (5), p.e004642-e004642</ispartof><rights>2018 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c318t-ba595b80001e36116d0abff4747b5ad64211df85139330c10b1ca65ef47637bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,3674,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29716899$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Breathett, Khadijah</creatorcontrib><creatorcontrib>Leng, Iris</creatorcontrib><creatorcontrib>Foraker, Randi E</creatorcontrib><creatorcontrib>Abraham, William T</creatorcontrib><creatorcontrib>Coker, Laura</creatorcontrib><creatorcontrib>Whitfield, Keith E</creatorcontrib><creatorcontrib>Shumaker, Sally</creatorcontrib><creatorcontrib>Manson, JoAnn E</creatorcontrib><creatorcontrib>Eaton, Charles B</creatorcontrib><creatorcontrib>Howard, Barbara V</creatorcontrib><creatorcontrib>Ijioma, Nkechinyere</creatorcontrib><creatorcontrib>Cené, Crystal W</creatorcontrib><creatorcontrib>Martin, Lisa W</creatorcontrib><creatorcontrib>Johnson, Karen C</creatorcontrib><creatorcontrib>Klein, Liviu</creatorcontrib><title>Risk Factor Burden, Heart Failure, and Survival in Women of Different Ethnic Groups: Insights From the Women's Health Initiative</title><title>Circulation. Heart failure</title><addtitle>Circ Heart Fail</addtitle><description>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.
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 (
<0.0001, interaction of race/ethnicity and RF number
=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 (
<0.0001) but differed by racial/ethnic group (interaction
=0.001). The number of RFs was not associated with the risk of death after developing HF in any group (
=0.25; interaction
=0.48).
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.</description><subject>Aged</subject><subject>Black or African American</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Heart Failure - mortality</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Proportional Hazards Models</subject><subject>Racial Groups</subject><subject>Risk Factors</subject><subject>Survival Analysis</subject><subject>Women's Health</subject><issn>1941-3289</issn><issn>1941-3297</issn><issn>1941-3297</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUV1LwzAUDaL4Mf0LEvBBH9xMlqZtFIQ5NzcYCFPxMaRtaqNtMpN04Js_3cjmUJ9uOPecc-_NAeAEox7GMb4YTufDyWgwfxwPprOn-SigSQ-hKI76W2Afswh3SZ8l25t3yvbAgXOvCMV9Stku2AttHKeM7YPPuXJvcCxybyy8aW0h9TmcSGF9AFXdWnkOhS7gQ2uXailqqDR8No3U0JTwVpWltFJ7OPKVVjm8s6ZduEs41U69VN7BsTUN9JVcaU7dt3Xtq0BQXgmvlvIQ7JSidvJoXTvgaTx6HE66s_u76XAw6-YEp76bCcpoliKEsCRx-IcCiawsoyRKMiqKcDvGRZlSTBghKMcow7mIqQyMmCRZQTrgeuW7aLNGFnnY2oqaL6xqhP3gRij-t6NVxV_MklNGgisNBmdrA2veW-k8b5TLZV0LLU3reB8RQpIYh9oBVytqbo1zVpabMRjx7wz5_wwDmvBVhkF9_HvTjfYnNPIF-06bWw</recordid><startdate>201805</startdate><enddate>201805</enddate><creator>Breathett, Khadijah</creator><creator>Leng, Iris</creator><creator>Foraker, Randi E</creator><creator>Abraham, William T</creator><creator>Coker, Laura</creator><creator>Whitfield, Keith E</creator><creator>Shumaker, Sally</creator><creator>Manson, JoAnn E</creator><creator>Eaton, Charles B</creator><creator>Howard, Barbara V</creator><creator>Ijioma, Nkechinyere</creator><creator>Cené, Crystal W</creator><creator>Martin, Lisa W</creator><creator>Johnson, Karen C</creator><creator>Klein, Liviu</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201805</creationdate><title>Risk Factor Burden, Heart Failure, and Survival in Women of Different Ethnic Groups: Insights From the Women's Health Initiative</title><author>Breathett, Khadijah ; Leng, Iris ; Foraker, Randi E ; Abraham, William T ; Coker, Laura ; Whitfield, Keith E ; Shumaker, Sally ; Manson, JoAnn E ; Eaton, Charles B ; Howard, Barbara V ; Ijioma, Nkechinyere ; Cené, Crystal W ; Martin, Lisa W ; Johnson, Karen C ; Klein, Liviu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c318t-ba595b80001e36116d0abff4747b5ad64211df85139330c10b1ca65ef47637bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Black or African American</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Heart Failure - mortality</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Proportional Hazards Models</topic><topic>Racial Groups</topic><topic>Risk Factors</topic><topic>Survival Analysis</topic><topic>Women's Health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Breathett, Khadijah</creatorcontrib><creatorcontrib>Leng, Iris</creatorcontrib><creatorcontrib>Foraker, Randi E</creatorcontrib><creatorcontrib>Abraham, William T</creatorcontrib><creatorcontrib>Coker, Laura</creatorcontrib><creatorcontrib>Whitfield, Keith E</creatorcontrib><creatorcontrib>Shumaker, Sally</creatorcontrib><creatorcontrib>Manson, JoAnn E</creatorcontrib><creatorcontrib>Eaton, Charles B</creatorcontrib><creatorcontrib>Howard, Barbara V</creatorcontrib><creatorcontrib>Ijioma, Nkechinyere</creatorcontrib><creatorcontrib>Cené, Crystal W</creatorcontrib><creatorcontrib>Martin, Lisa W</creatorcontrib><creatorcontrib>Johnson, Karen C</creatorcontrib><creatorcontrib>Klein, Liviu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Circulation. Heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Breathett, Khadijah</au><au>Leng, Iris</au><au>Foraker, Randi E</au><au>Abraham, William T</au><au>Coker, Laura</au><au>Whitfield, Keith E</au><au>Shumaker, Sally</au><au>Manson, JoAnn E</au><au>Eaton, Charles B</au><au>Howard, Barbara V</au><au>Ijioma, Nkechinyere</au><au>Cené, Crystal W</au><au>Martin, Lisa W</au><au>Johnson, Karen C</au><au>Klein, Liviu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factor Burden, Heart Failure, and Survival in Women of Different Ethnic Groups: Insights From the Women's Health Initiative</atitle><jtitle>Circulation. Heart failure</jtitle><addtitle>Circ Heart Fail</addtitle><date>2018-05</date><risdate>2018</risdate><volume>11</volume><issue>5</issue><spage>e004642</spage><epage>e004642</epage><pages>e004642-e004642</pages><issn>1941-3289</issn><issn>1941-3297</issn><eissn>1941-3297</eissn><abstract>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.
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 (
<0.0001, interaction of race/ethnicity and RF number
=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 (
<0.0001) but differed by racial/ethnic group (interaction
=0.001). The number of RFs was not associated with the risk of death after developing HF in any group (
=0.25; interaction
=0.48).
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.</abstract><cop>United States</cop><pmid>29716899</pmid><doi>10.1161/CIRCHEARTFAILURE.117.004642</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1941-3289 |
| ispartof | Circulation. Heart failure, 2018-05, Vol.11 (5), p.e004642-e004642 |
| issn | 1941-3289 1941-3297 1941-3297 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5935135 |
| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Black or African American Ethnicity Female Heart Failure - mortality Humans Middle Aged Proportional Hazards Models Racial Groups Risk Factors Survival Analysis Women's Health |
| title | Risk Factor Burden, Heart Failure, and Survival in Women of Different Ethnic Groups: Insights From the Women's Health Initiative |
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