Abstract P378: Heart Failure Incidence and Mortality in the Southern Community Cohort Study
Background and objectives: Heart failure (HF) is a major public health problem; however, there is a paucity of data regarding HF incidence among low income and minority populations. We estimated HF incidence rates (IR) and post-HF mortality rates (MR) by race and gender in the Southern Community Cohort Study (SCCS), a prospective study of adults enrolled between 2002-2009 in the southeastern US.
Methods: Among 20,030 white and black SCCS participants without prevalent HF who were receiving Medicare or Medicaid during follow-up through December 31, 2011 (mean age 57 yrs; 69% black, 65% female, 71% income < $15,000/yr), incident HF diagnoses were ascertained using ICD-9 codes 428.x via linkage with Centers for Medicare and Medicaid Services Research Identifiable Files. We computed HF IR and post-HF MR by race and sex. Risk of HF was calculated using multivariable Cox proportional hazards models.
Results: HF risk factors were common: hypertension (66%), diabetes (29%), myocardial infarction (11%), and obesity (46%). Over a median follow up of 6 years, 2,384 participants developed HF (IR: 20.5/1000 person-years; 95% CI: 19.7, 21.4). White males had the highest IR, 24.3/1000 PY, compared to 20.7, 20.4 and 19.6 in white females, black males and black females, respectively. After adjustment for age, income, education, and clinical risk factors, male sex remained a significant predictor of HF risk [HR: 1.19; 95%CI: 1.09, 1.31], but the race-sex interaction was not statistically significant (p=0.11). Among incident HF cases, 689 (28.9%) died (MR: 86.8/1000 person-years; 95%CI: 80.2, 93.9), with the highest MR in white males (143.5/1000PY) compared to black males (104.5), white females (72.4), and black females (71.6) (Figure).
Conclusion: In this low-income, predominantly black population, IR and MR for HF were higher for all race and sex groups than previously reported in other multiethnic cohorts. The SCCS is a unique resource to investigate determinants of HF risk in a segment of the population underrepresented in other existing cohorts.
Author Disclosures: E.A. Akwo: None. E.K. Kabagambe: None. T.J. Wang: None. F.E. Harrell: None. W.J. Blot: None. D.K. Gupta: None. L. Lipworth: None.
- © 2015 by American Heart Association, Inc.