Abstract 3105: Lifetime Risk for Developing Heart Failure by Sex and Race at Selected Ages in Multiple Cohorts: Cardiovascular Lifetime Risk Pooling Project
BACKGROUND: Lifetime risk for developing heart failure (HF) was previously estimated to be 20% to 33% in two cohorts of white individuals. Short-term risks for HF appear to be higher for blacks than whites, but no comparisons of lifetime risk for HF have been made between these race groups.
METHODS: Using longitudinal data (including public-release datasets) from NHLBI-sponsored cohorts from 1967 up to 2003, we estimated lifetime risk for developing overt HF to age 95, with death free of heart failure as the competing event, among participants who were free of HF at selected index ages in the Chicago Heart Association (CHA), Cardiovascular Health (CHS) and Atherosclerosis Risk in Communities (ARIC) studies.
RESULTS: There were a total of 58,951 participants, (48% women; 50,139 white; 8812 black) followed for 991,471 person-years; 7024 participants developed HF. The Table⇓ shows lifetime risks for selected age-sex-race strata. Unadjusted cumulative incidence rates of HF were substantially greater in black than white men, but adjustment for competing risk of death diminished their overall lifetime risks for HF. At age 65 years, the remaining lifetime risk for HF to age 95 years in CHA and CHS was 42– 46% in white men and 35–37% in black men; lifetime risk for HF was 40 – 42% in white women and 35–51% in black women. In ARIC, lifetime risks for HF were similar to CHA and CHS in blacks and whites to age 75 years (limit of follow-up). Remaining lifetime risks for HF remained similarly high at all index ages, despite shorter life expectancy at older ages. Lifetime risk for HF was higher with higher blood pressure and BMI at all ages in both blacks and whites.
CONCLUSIONS: These are the first data to compare lifetime risks for HF between blacks and whites. Lifetime risks for HF are very high and appear similar for black and white men and women. Risk factors (hypertension and obesity) previously described to increase lifetime risks for HF in whites also appear to increase lifetime risks in blacks.