PHILADELPHIA — Over time, the disparity gap in HF prevalence among black adults compared with white adults has widened and the odds of HF remain significantly higher in the black population, according to research presented at Heart Failure Society of America Scientific Meeting.
Of the 20,290 participants (mean age, 55 years; 52% women; 12% black), age-adjusted prevalence of HF per 100,000 black people increased from 3,921 between 1999 and 2000 to 6,568 between 2015 and 2016 (P < .05). However, overall HF prevalence per 100,000 white people remained consistent over the same period (P > .05)
“In terms of heart failure prevalence, we saw an increasing trend in HF prevalence in black adults between 1999 and 2016 and in whites, we did not see the same trend,” Leah Rethy, visiting scholar, pre-doctoral research fellow and Sarnoff Cardiovascular Research Fellow at Northwestern University Feinberg School of Medicine, said during a presentation. “In fact, HF prevalence seemed stable over time. In examining age-adjusted HF, which adjusted for both age and sex as well as regional cardiovascular risk factors, eGFR and socioeconomic status, which was based on highest level of education achieved as well as health insurance status, we did see significant differences by race, particularly in the last two periods examined, 2005 to 2010 and 2011 to 2016.”
In 2005 to 2010, odds of HF in black adults were more than 50% higher than for white adults after adjustment for age, sex, CVD risk factors, glomerular filtration rate and socioeconomic status (adjusted OR = 1.51; 95% CI, 1.11-2.04), and the same was true for 2011 to 2016 (aOR = 1.55; 95% CI, 1.16-2.06), according to the researchers, who noted the differences were driven by people aged 35 to 64 years.
Using data from the National Health and Nutrition Examination Survey, researchers analyzed nonpregnant adults aged 35 years or older who identified as non-Hispanic black or white. Age-adjusted HF prevalence was assessed on a 2-year cycle. ORs as well as confidence intervals were calculated by pooling cycles into 6-year periods with adjustment for age, sex, CV risk factors, renal function and socioeconomic status as determined by education level and health insurance status.
“We believe that due to the fact that the incidences are self-reported, we are likely underestimating the prevalence of HF in this population,” Rethy said in the presentation. “Resources and research are further needed to characterize and reduce the racial disparities that we see and untangle the complicated interplay of epigenetic factors as well as other risk factors that we are unable to account for.” – by Scott Buzby
Rethy L, et al. Abstract 025. Presented at: Heart Failure Society of America Scientific Meeting; Sept. 13-16, 2019; Philadelphia.
Disclosure: Rethy reports no relevant financial disclosures.