title: Heart Failure Incidence and Mortality in the Southern Community Cohort Study.
abstract: BACKGROUND
  There is a paucity of data on heart failure (HF) incidence among low-income and minority populations. Our objective was to investigate HF incidence and post-HF survival by race and sex among low-income adults in the southeastern United States.
  
  
  RESULTS
  Participants were 27 078 white and black men and women enrolled during 2002 to 2009 in the SCCS (Southern Community Cohort Study) who had no history of HF and were receiving Centers for Medicare and Medicaid Services. Incident HF diagnoses through December 31, 2010 were ascertained usingInternational Classification of Diseases9th Revision codes 428.x via linkage with Centers for Medicare and Medicaid Services research files. Most participants were black (68.8%), women (62.6%), and earned <$15 000/y (69.7%); mean age was 55.5 (10.4) years. Risk factors for HF were common: hypertension (62.5%), diabetes mellitus (26.5%), myocardial infarction (8.6%), and obesity (44.8%). Over a median follow-up of 5.2 years, 4341 participants were diagnosed with HF. The age-standardized incidence rates were 34.8, 37.3, 34.9, and 35.6 /1000 person-years in white women, white men, black men, and black women, respectively, remarkably higher than previously reported. Among HF cases, 952 deaths occurred over a median follow-up of 2.3 years. Men had lower survival; hazard ratios and 95% confidence intervals were 1.63 (1.27-2.08), 1.38 (1.11-1.72), and 0.90 (0.73-1.12) for white men, black men, and black women compared with white women.
  
  
  CONCLUSIONS
  In this low-income population, HF incidence was higher for all race-sex groups than previously reported in other cohorts. The SCCS is a unique resource to investigate determinants of HF risk in a segment of the population underrepresented in other existing cohorts.
authors.affiliation: From the Division of Epidemiology (E.A.A., E.K.K., W.J.B., L.L.), Division of Cardiovascular Medicine (T.J.W., D.K.G.), and Vanderbilt Translational and Clinical Cardiovascular Research Center (V-TRACC) (E.A.A., E.K.K., T.J.W., F.E.H., D.K.G., L.L.), Department of Medicine, and Department of Biostatistics (F.E.H.), Vanderbilt University School of Medicine, Nashville, TN; and Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN (M.M.).
authors.forename: Elvis A
authors.initials: EA
authors.lastname: Akwo
authors.affiliation: From the Division of Epidemiology (E.A.A., E.K.K., W.J.B., L.L.), Division of Cardiovascular Medicine (T.J.W., D.K.G.), and Vanderbilt Translational and Clinical Cardiovascular Research Center (V-TRACC) (E.A.A., E.K.K., T.J.W., F.E.H., D.K.G., L.L.), Department of Medicine, and Department of Biostatistics (F.E.H.), Vanderbilt University School of Medicine, Nashville, TN; and Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN (M.M.).
authors.forename: Edmond K
authors.initials: EK
authors.lastname: Kabagambe
authors.affiliation: From the Division of Epidemiology (E.A.A., E.K.K., W.J.B., L.L.), Division of Cardiovascular Medicine (T.J.W., D.K.G.), and Vanderbilt Translational and Clinical Cardiovascular Research Center (V-TRACC) (E.A.A., E.K.K., T.J.W., F.E.H., D.K.G., L.L.), Department of Medicine, and Department of Biostatistics (F.E.H.), Vanderbilt University School of Medicine, Nashville, TN; and Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN (M.M.).
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
authors.affiliation: From the Division of Epidemiology (E.A.A., E.K.K., W.J.B., L.L.), Division of Cardiovascular Medicine (T.J.W., D.K.G.), and Vanderbilt Translational and Clinical Cardiovascular Research Center (V-TRACC) (E.A.A., E.K.K., T.J.W., F.E.H., D.K.G., L.L.), Department of Medicine, and Department of Biostatistics (F.E.H.), Vanderbilt University School of Medicine, Nashville, TN; and Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN (M.M.).
authors.forename: Frank E
authors.initials: FE
authors.lastname: Harrell
authors.affiliation: From the Division of Epidemiology (E.A.A., E.K.K., W.J.B., L.L.), Division of Cardiovascular Medicine (T.J.W., D.K.G.), and Vanderbilt Translational and Clinical Cardiovascular Research Center (V-TRACC) (E.A.A., E.K.K., T.J.W., F.E.H., D.K.G., L.L.), Department of Medicine, and Department of Biostatistics (F.E.H.), Vanderbilt University School of Medicine, Nashville, TN; and Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN (M.M.).
authors.forename: William J
authors.initials: WJ
authors.lastname: Blot
authors.affiliation: From the Division of Epidemiology (E.A.A., E.K.K., W.J.B., L.L.), Division of Cardiovascular Medicine (T.J.W., D.K.G.), and Vanderbilt Translational and Clinical Cardiovascular Research Center (V-TRACC) (E.A.A., E.K.K., T.J.W., F.E.H., D.K.G., L.L.), Department of Medicine, and Department of Biostatistics (F.E.H.), Vanderbilt University School of Medicine, Nashville, TN; and Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN (M.M.).
authors.forename: Michael
authors.initials: M
authors.lastname: Mumma
authors.affiliation: From the Division of Epidemiology (E.A.A., E.K.K., W.J.B., L.L.), Division of Cardiovascular Medicine (T.J.W., D.K.G.), and Vanderbilt Translational and Clinical Cardiovascular Research Center (V-TRACC) (E.A.A., E.K.K., T.J.W., F.E.H., D.K.G., L.L.), Department of Medicine, and Department of Biostatistics (F.E.H.), Vanderbilt University School of Medicine, Nashville, TN; and Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN (M.M.).
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Gupta
authors.affiliation: From the Division of Epidemiology (E.A.A., E.K.K., W.J.B., L.L.), Division of Cardiovascular Medicine (T.J.W., D.K.G.), and Vanderbilt Translational and Clinical Cardiovascular Research Center (V-TRACC) (E.A.A., E.K.K., T.J.W., F.E.H., D.K.G., L.L.), Department of Medicine, and Department of Biostatistics (F.E.H.), Vanderbilt University School of Medicine, Nashville, TN; and Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN (M.M.). loren.lipworth@vanderbilt.edu.
authors.forename: Loren
authors.initials: L
authors.lastname: Lipworth
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D015144:Southeastern United States / Q000453:epidemiology; D013997:Time Factors; D044465:White People
keywords: epidemiology; heart failure; incidence; population; survival