Abstract 3650: Differences in The Incidence and Predictors of Heart Failure by Racial/Ethnic Group: Multi-Ethnic Study of Atherosclerosis
Background: Race/ethnicity is associated with hospitalization for heart failure (HF), however the relationship between incident HF and ethnicity in a multi-racial population has not been well studied. We determined the association of ethnicity with incident CHF, independent of traditional risk factors (Table⇓ footnote), left ventricular (LV) function at baseline, and interim myocardial infarction.
Methods: Multi-Ethnic Study of Atherosclerosis (MESA) is a cohort study of 6,814 participants who identified themselves as Caucasians (38%), African Americans (28%), Hispanics (22%), and Chinese Americans (12%). Cox proportional hazards models were used for data analysis.
Results: Seventy-nine participants developed HF during a median follow-up of 4.0 years (incidence rate: 3.1 per 1000 person-years). African Americans had the highest incidence rate of HF, followed by Hispanics, Caucasians, and Chinese (incidence rates: 4.6, 3.5, 2.4, and 1.0 per 1000 person-years, respectively). Compared to Caucasians, African Americans were at a higher risk for developing HF (hazard ratio [HR]:1.8, p:0.03). There was not a significant difference in risk of HF between other ethnicities and Caucasians (Table⇓). Adding hypertension and/or diabetes mellitus to models including ethnicity resulted in a considerable reduction in the HR for HF in African Americans vs. Caucasians, making that association no longer statistically significant. Similar results were seen when household income, as a measure of socioeconomic status, was added to the models. Ethnicity modified the association of LV mass with incident HF (a certain increase in LV mass index was associated with lower increase in risk in African Americans and Hispanics).
Conclusions: The incidence of HF was higher in African Americans, compared to MESA participants of other ethnicities. This disparity in risk of HF was related to differences in prevalence of established risk factors, specifically hypertension and diabetes.