The lifetime risk for HF with preserved ejection fraction and HF with reduced ejection fraction differed by race, sex and history of MI, according to a study published in Circulation.
Ambarish Pandey, MD, second-year clinical fellow in the division of cardiology at the University of Texas Southwestern Medical Center in Dallas, and colleagues analyzed data from 12,417 participants (45% men; 22% black) from the Cardiovascular Health Study (CHS) and Multi-Ethnic Study of Atherosclerosis (MESA) who were older than 45 years and did not have prevalent HF at baseline. Information on baseline risk factors was either self-reported or measured. History of diabetes and CAD were self-reported and then confirmed by medications used at the initial visit.
The primary outcomes of interest were the incidence of HF, HFrEF and HFpEF. Follow-up in the MESA cohort was conducted over the phone, which was then verified by reviewing medical records. CMS claims data, medical records review and participant surveys were used in the CHS cohort to identify HF events.
Researchers calculated lifetime risk for HF, which was set at 90 years. Participants were followed up until age 90 years, first HF event or death. The lifetime risk for HFpEF and HFrEF was calculated at age 45, 55, 65 and 75 years.
During a median follow-up of 11.6 years, 2,178 incident HF events occurred, including 726 HFpEF events and 561 HFrEF events.
The lifetime risk for any HF event from age 45 to 90 years was 27.4% in men and 23.8% in women. Men also had a higher risk for HFrEF (10.6%) compared with women (5.8%). The risk for HFpEF was similar in men (10.4%) and women (10.7%).
Non-black participants had an increased lifetime risk for any HF event (25.9%) compared with black participants (22.4%). The lifetime risk for HFpEF was also higher in non-black participants (11.2%) vs. black participants (7.7%). Black and non-black participants had similar a lifetime risk for HFrEF (7.7% vs. 7.9%, respectively).
Participants with a history of MI had a 2.5-fold higher risk for HFpEF and a fourfold higher risk for HFrEF compared with those without antecedent MI.
“Our study findings provide insights into the lifestyle risk of HF subtypes across relevant population subgroups,” Pandey and colleagues wrote. “These data may guide health policymakers and public health investigators to predict the relative population burden of the two distinct HF subtypes. It will also help identify the high-risk patient population for HFrEF and HFpEF and allow for appropriate disease-specific resource allocation and targeting of preventive strategies.” – by Darlene Dobkowski
The authors report no relevant financial disclosures.