Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies

2021 ◽  
Author(s):  
Rebecca S. Steinberg ◽  
Aditi Nayak ◽  
Michael A. Burke ◽  
Morgan Aldridge ◽  
S. Raja Laskar ◽  
...  
Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kavita Sharma ◽  
Sunil K Agarwal ◽  
Lisa M Wrick ◽  
Kunihiro Matsushita ◽  
Patricia P Chang ◽  
...  

Background: Heart failure with preserved ejection fraction (HFpEF) accounts for about half of HF hospitalizations, and has been reported to be more common amongst Caucasians and women in outpatient population studies. There are limited data, however, on the influence of race and gender on survival in HFpEF. We evaluated whether clinical characteristics and outcomes differ amongst HFpEF patients by race and gender. Methods: HFpEF (EF≥ 50%) hospitalization cases from 2005-2009 adjudicated by a physician panel were analyzed from the community-based surveillance component of the ARIC study, comprising 4 US communities (Jackson, MS; Washington County, MD; Minneapolis, MN; and Forsyth County, NC; combined population in 2009 = 214,000). The association of race and gender with mortality at 28-days and 1-year was evaluated. Results: Of 3,786 (weighted n = 18,265) adjudicated acute decompensated HF cases, 1,726 (weighted n = 8114) were categorized as HFpEF. Patient characteristics included: female (44%), African American (AA, 32%), hypertension (83%), diabetes (46%), and mean BMI of 28. Compared to Caucasians, AA’s were younger (70 vs. 77 years, p<0.001), more frequently women (47% vs. 42%, p<0.001), with higher systolic blood pressure (SBP, 145 vs. 135 mmHg, p<0.001), and more prior HF hospitalizations (50% vs. 37%, p<0.001). Compared to men, women were older (76 vs. 73 years, p<0.001), with higher SBP (141 vs. 138 mmHg, p=0.03), and better renal function (eGFR 42 vs. 38 mL/min/1.73m 2 , p<0.001). Overall 28-day and 1-year mortality was 13.1% and 32.8%, respectively, with no differences in un-adjusted or adjusted estimates by race or gender (Table 1). Conclusions: In hospitalized HFpEF patients, overall 28-day and 1-year mortality were high without apparent race- or gender-based differences in mortality. These data may help inform the development of future interventions and resource allocation.


Heart & Lung ◽  
2019 ◽  
Vol 48 (3) ◽  
pp. 201-207 ◽  
Author(s):  
Christine A. Haedtke ◽  
Debra K. Moser ◽  
Susan J. Pressler ◽  
Misook L. Chung ◽  
Sue Wingate ◽  
...  

2003 ◽  
Vol 41 (6) ◽  
pp. 183
Author(s):  
Lynne C. Einbinder ◽  
Meenakshi Khatta ◽  
Brianne Sigler ◽  
Sue Ann Thomas ◽  
Erika Friedman ◽  
...  

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Omar Chehab ◽  
Maria Doughan ◽  
Rami Z. Morsi ◽  
Amjad Kanj ◽  
Ali Abdallah ◽  
...  

Introduction: Periodontal disease (PD) is an acquired disorder characterized by inflammation of the gums, resulting eventually in loss of teeth. Epidemiological studies have shown a link between PD and cardiovascular diseases (CVDs). The aim of this study is to evaluate differences in the prevalence of CVD amongst US patients with PD of different age, race and sex. Method: Using the US national in-patient sample database (NIS) from 2005-2014, patients with PD and CVD were identified. Results: 155,732 hospitalizations with PD were included in the study, of which 36.5% had at least one CVD. Ischemic heart disease was the most prevalent CVD (17.6%), followed by heart failure (10.9%), atrial fibrillation/flutter (10.1%) and cerebrovascular disease (CRVD) (9.7%). The overall in-hospital mortality was higher in PD patients with CVD (2.6% vs 1.2%, p<0.0001). Figure 1C highlights the prevalence of various subtypes of CVD among different gender. When stratifying hospitalized patients with PD and CVD based on race and age, there was higher prevalence of CVD among Asians and Pacific Islanders (42.4%) (Figure 1A-B) and with increasing age (≥70, 56-69, and 18-55; 67.4% vs 50.1% vs 20.3%, p<0.001, respectively). Significant increase trends in the prevalence of AF, HF, and CRVD in the young, middle, and older age group was noted (P-trend<0.001) (Figure1A). Conclusion: CVD is prevalent in patients with PD and is more common in males and among Asians and Pacific Islanders. Higher mortality was reported among hospitalized PD patients with CVD. An increase in trend in the prevalence of AF, HF, and CRVD was noted across all age groups. This may require age, race, and gender specific strategies in PD patients for primary prevention of different CVD.


Medical Care ◽  
1999 ◽  
Vol 37 (12) ◽  
pp. 1260-1269 ◽  
Author(s):  
John Z. Ayanian ◽  
Joel S. Weissman ◽  
Scott Chasan-Taber ◽  
Arnold M. Epstein

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Matthew Mefford ◽  
George Howard ◽  
Raegan Durant ◽  
Nancy Dunlap ◽  
Parag Goyal ◽  
...  

Background: Hypertension is a major risk factor for heart failure (HF), but associations of hypertension with HF may vary by race and gender. Objective: To assess race and gender differences in the association between hypertension and incident HF hospitalization in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Methods: REGARDS participants without suspected baseline HF (n = 25,759) were followed from study entry in 2003-2007 through 2014 with adjudication of incident HF hospitalizations (n = 855). Hypertension was defined as systolic or diastolic blood pressure ≥ 140/90 mmHg or self-reported antihypertensive medication use. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for the association between hypertension and HF hospitalization in subgroups separately by race or gender, with each subgroup model adjusted for race, gender, age, income, region of residence, health insurance, body mass index, smoking, history of coronary heart disease, diabetes, reduced estimated glomerular filtration rate, total cholesterol, statin use, physical activity, perceived stress, and depressive symptoms. Results: The mean age of the population was 64.5 years, 40.0% were black and 55.0% were female. The prevalence of hypertension was 57.1% and more common among blacks (69.3%) compared to whites (48.9%) but similar among males (56.5%) and females (57.6%). Over a median follow-up of 8.4 years, incidence rates for HF hospitalization were 4.19, 4.46, 5.14 and 4.29 per 1,000 person-years for whites, blacks, males and females, respectively. After multivariable adjustment, the association between hypertension and HF was stronger among blacks versus whites (HR 2.28 vs HR 1.50, p-interaction=0.04) and similar among males and females (HR 1.61 vs HR 1.83, p-interaction=0.19). ( Figure ) Conclusion: Hypertension may be a stronger risk factor for incident HF among blacks versus whites. This finding may be due to disparities in hypertension severity, control, or duration.


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