Epidemiology of incident heart failure in a contemporary elderly cohort: the health, aging, and body composition study.
BACKGROUND
The race- and sex-specific epidemiology of incident heart failure (HF) among a contemporary elderly cohort are not well described.


METHODS
We studied 2934 participants without HF enrolled in the Health, Aging, and Body Composition Study (mean [SD] age, 73.6 [2.9] years; 47.9% men; 58.6% white; and 41.4% black) and assessed the incidence of HF, population-attributable risk (PAR) of independent risk factors for HF, and outcomes of incident HF.


RESULTS
During a median follow-up of 7.1 years, 258 participants (8.8%) developed HF (13.6 cases per 1000 person-years; 95% confidence interval, 12.1-15.4). Men and black participants were more likely to develop HF. No significant sex-based differences were observed in risk factors. Coronary heart disease (PAR, 23.9% for white participants and 29.5% for black participants) and uncontrolled blood pressure (PAR, 21.3% for white participants and 30.1% for black participants) carried the highest PAR in both races. Among black participants, 6 of 8 risk factors assessed (smoking, increased heart rate, coronary heart disease, left ventricular hypertrophy, uncontrolled blood pressure, and reduced glomerular filtration rate) had more than 5% higher PAR compared with that among white participants, leading to a higher overall proportion of HF attributable to modifiable risk factors in black participants vs white participants (67.8% vs 48.9%). Participants who developed HF had higher annual mortality (18.0% vs 2.7%). No racial difference in survival after HF was noted; however, rehospitalization rates were higher among black participants (62.1 vs 30.3 hospitalizations per 100 person-years, P < .001).


CONCLUSIONS
Incident HF is common in older persons; a large proportion of HF risk is attributed to modifiable risk factors. Racial differences in risk factors for HF and in hospitalization rates after HF need to be considered in prevention and treatment efforts.
Cardiology Division, Emory University Hospital, Emory University, 1365 Clifton Rd NE, Ste AT430, Atlanta, GA 30322, USA.
Andreas
A
Kalogeropoulos
Vasiliki
V
Georgiopoulou
Stephen B
SB
Kritchevsky
Bruce M
BM
Psaty
Nicholas L
NL
Smith
Anne B
AB
Newman
Nicolas
N
Rodondi
Suzanne
S
Satterfield
Douglas C
DC
Bauer
Kirsten
K
Bibbins-Domingo
Andrew L
AL
Smith
Peter W F
PW
Wilson
Ramachandran S
RS
Vasan
Tamara B
TB
Harris
Javed
J
Butler
D017677:Age Distribution; D000368:Aged; D000375:Aging / Q000502:physiology*; D001823:Body Composition / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology