title: Regional and ethnic differences among patients with heart failure in Asia: the Asian sudden cardiac death in heart failure registry.
abstract: To characterize regional and ethnic differences in heart failure (HF) across Asia.
  
  
  
  We prospectively studied 5276 patients with stable HF and reduced ejection fraction (≤40%) from 11 Asian regions (China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan, and Thailand). Mean age was 59.6 ± 13.1 years, 78.2% were men, and mean body mass index was 24.9 ± 5.1 kg/m2. Majority (64%) of patients had two or more comorbid conditions such as hypertension (51.9%), coronary artery disease (CAD, 50.2%), or diabetes (40.4%). The prevalence of CAD was highest in Southeast Asians (58.8 vs. 38.2% in Northeast Asians). Compared with Chinese ethnicity, Malays (adjusted odds ratio [OR] 1.97, 95% CI 1.63-2.38) and Indians (OR 1.44, 95% CI 1.24-1.68) had higher odds of CAD, whereas Koreans (OR 0.38, 95% CI 0.29-0.50) and Japanese (OR 0.44, 95% CI 0.36-0.55) had lower odds. The prevalence of hypertension and diabetes was highest in Southeast Asians (64.2 and 49.3%, respectively) and high-income regions (59.7 and 46.2%, respectively). There was significant interaction between ethnicity and region, where the adjusted odds were 3.95 (95% CI 2.51-6.21) for hypertension and 4.91 (95% CI 3.07-7.87) for diabetes among Indians from high- vs. low-income regions; and 2.60 (95% CI 1.66-4.06) for hypertension and 2.62 (95% CI 1.73-3.97) for diabetes among Malays from high- vs. low-income regions.
  
  
  
  These first prospective multi-national data from Asia highlight the significant heterogeneity among Asian patients with stable HF, and the important influence of both ethnicity and regional income level on patient characteristics.
  
  
  
  NCT01633398.
authors: National Heart Centre Singapore, Singapore, Singapore carolyn.lam@duke-nus.edu.sg.|Duke-National University of Singapore, Singapore, Singapore.|Cardiovascular Research Institute, National University Heart Centre, Singapore, Singapore.
authors: Carolyn S P
authors: CS
authors: Lam
authors: National Heart Centre Singapore, Singapore, Singapore.|School of Population Health, University of Western Australia, WA, Australia.
authors: Tiew-Hwa Katherine
authors: TK
authors: Teng
authors: National Heart Centre Singapore, Singapore, Singapore.
authors: Wan Ting
authors: WT
authors: Tay
authors: VA Medical Center, University of Minnesota, Minneapolis, USA.
authors: Inder
authors: I
authors: Anand
authors: Fuwai Hospital, Beijing, The People's Republic of China.
authors: Shu
authors: S
authors: Zhang
authors: National Cardiovascular Centre, Tokyo, Japan.
authors: Wataru
authors: W
authors: Shimizu
authors: CARE Hospital, Hyderabab, India.
authors: Calambur
authors: C
authors: Narasimhan
authors: Korea University Hospital, Seoul, Korea.
authors: Sang Weon
authors: SW
authors: Park
authors: Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, The People's Republic of China.
authors: Cheuk-Man
authors: CM
authors: Yu
authors: Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors: Tachapong
authors: T
authors: Ngarmukos
authors: Institut Jantung Negara, Kuala Lumpur, Malaysia.
authors: Razali
authors: R
authors: Omar
authors: Manila Doctors Hospital, Manila, Philippines.
authors: Eugene B
authors: EB
authors: Reyes
authors: National Cardiovascular Center Universitas Indonesia, Jakarta, Indonesia.
authors: Bambang B
authors: BB
authors: Siswanto
authors: Mackay Memorial Hospital, Taipei, Taiwan.
authors: Chung-Lieh
authors: CL
authors: Hung
authors: Cardiovascular Research Institute, National University Heart Centre, Singapore, Singapore.
authors: Lieng H
authors: LH
authors: Ling
authors: National Heart Centre Singapore, Singapore, Singapore.
authors: Jonathan
authors: J
authors: Yap
authors: Changi General Hospital, Singapore, Singapore.
authors: Michael
authors: M
authors: MacDonald
authors: Cardiovascular Research Institute, National University Heart Centre, Singapore, Singapore.
authors: A Mark
authors: AM
authors: Richards
mesh_terms: D044466:Asian People; D016757:Death, Sudden, Cardiac; D005260:Female; D006333:Heart Failure; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries
keywords: Asia; Epidemiology; Ethnicity; Heart failure; Risk factors