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Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis.

Abstract

BACKGROUND

The relationship between incident congestive heart failure (CHF) and ethnicity as well as racial/ethnic differences in the mechanisms leading to CHF have not been demonstrated in a multiracial, population-based study. Our objective was to evaluate the relationship between race/ethnicity and incident CHF.

METHODS

The Multi-Ethnic Study of Atherosclerosis (MESA) is a cohort study of 6814 participants of 4 ethnicities: white (38.5%), African American (27.8%), Hispanic (21.9%), and Chinese American (11.8%). Participants with a history of cardiovascular disease at baseline were excluded. Cox proportional hazards models were used for data analysis.

RESULTS

During a median follow-up of 4.0 years, 79 participants developed CHF (incidence rate: 3.1 per 1000 person-years). African Americans had the highest incidence rate of CHF, followed by Hispanic, white, and Chinese American participants (incidence rates: 4.6, 3.5, 2.4, and 1.0 per 1000 person-years, respectively). Although risk of developing CHF was higher among African American compared with white participants (hazard ratio, 1.8; 95% confidence interval, 1.1-3.1), adding hypertension and/or diabetes mellitus to models including ethnicity eliminated statistical ethnic differences in incident CHF. Moreover, African Americans had the highest proportion of incident CHF not preceded by clinical myocardial infarction (75%) compared with other ethnic groups (P = .06).

CONCLUSIONS

The higher risk of incident CHF among African Americans was related to differences in the prevalence of hypertension and diabetes mellitus as well as socioeconomic status. The mechanisms of CHF also differed by ethnicity; interim myocardial infarction had the least influence among African Americans, and left ventricular mass increase had the greatest effect among Hispanic and white participants.

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  • Authors+Show Affiliations

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    Division of Cardiology, Department of Medicine, The Johns Hopkins University, Baltimore, MD 21287, USA.

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    Source

    Archives of internal medicine 168:19 2008 Oct 27 pg 2138-45

    MeSH

    Aged
    Aged, 80 and over
    Atherosclerosis
    Cardiomegaly
    Coronary Artery Disease
    Ethnic Groups
    Female
    Heart Failure
    Humans
    Incidence
    Male
    Middle Aged
    Myocardial Infarction
    Prevalence
    Risk Factors
    United States
    Ventricular Dysfunction, Left

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    18955644

    Citation

    Bahrami, Hossein, et al. "Differences in the Incidence of Congestive Heart Failure By Ethnicity: the Multi-ethnic Study of Atherosclerosis." Archives of Internal Medicine, vol. 168, no. 19, 2008, pp. 2138-45.
    Bahrami H, Kronmal R, Bluemke DA, et al. Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis. Arch Intern Med. 2008;168(19):2138-45.
    Bahrami, H., Kronmal, R., Bluemke, D. A., Olson, J., Shea, S., Liu, K., ... Lima, J. A. (2008). Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis. Archives of Internal Medicine, 168(19), pp. 2138-45. doi:10.1001/archinte.168.19.2138.
    Bahrami H, et al. Differences in the Incidence of Congestive Heart Failure By Ethnicity: the Multi-ethnic Study of Atherosclerosis. Arch Intern Med. 2008 Oct 27;168(19):2138-45. PubMed PMID: 18955644.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis. AU - Bahrami,Hossein, AU - Kronmal,Richard, AU - Bluemke,David A, AU - Olson,Jean, AU - Shea,Steven, AU - Liu,Kiang, AU - Burke,Gregory L, AU - Lima,João A C, PY - 2008/10/29/pubmed PY - 2008/12/17/medline PY - 2008/10/29/entrez SP - 2138 EP - 45 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 168 IS - 19 N2 - BACKGROUND: The relationship between incident congestive heart failure (CHF) and ethnicity as well as racial/ethnic differences in the mechanisms leading to CHF have not been demonstrated in a multiracial, population-based study. Our objective was to evaluate the relationship between race/ethnicity and incident CHF. METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) is a cohort study of 6814 participants of 4 ethnicities: white (38.5%), African American (27.8%), Hispanic (21.9%), and Chinese American (11.8%). Participants with a history of cardiovascular disease at baseline were excluded. Cox proportional hazards models were used for data analysis. RESULTS: During a median follow-up of 4.0 years, 79 participants developed CHF (incidence rate: 3.1 per 1000 person-years). African Americans had the highest incidence rate of CHF, followed by Hispanic, white, and Chinese American participants (incidence rates: 4.6, 3.5, 2.4, and 1.0 per 1000 person-years, respectively). Although risk of developing CHF was higher among African American compared with white participants (hazard ratio, 1.8; 95% confidence interval, 1.1-3.1), adding hypertension and/or diabetes mellitus to models including ethnicity eliminated statistical ethnic differences in incident CHF. Moreover, African Americans had the highest proportion of incident CHF not preceded by clinical myocardial infarction (75%) compared with other ethnic groups (P = .06). CONCLUSIONS: The higher risk of incident CHF among African Americans was related to differences in the prevalence of hypertension and diabetes mellitus as well as socioeconomic status. The mechanisms of CHF also differed by ethnicity; interim myocardial infarction had the least influence among African Americans, and left ventricular mass increase had the greatest effect among Hispanic and white participants. SN - 1538-3679 UR - https://www.unboundmedicine.com/medline/citation/18955644/full_citation L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.168.19.2138 DB - PRIME DP - Unbound Medicine ER -