The Complex Relationship of Race to Outcomes in Heart Failure with Preserved Ejection Fraction
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Authors
Gurwitz, Jerry H.Magid, David J.
Smith, David H.
Hsu, Grace
Sung, Sue Hee
Allen, Larry A.
McManus, David D.
Goldberg, Robert J.
Go, Alan S.
UMass Chan Affiliations
Department of MedicineDepartment of Quantitative Health Sciences
Meyers Primary Care Institute
Document Type
Journal ArticlePublication Date
2015-06-01Keywords
UMCCTS fundingCardiology
Cardiovascular Diseases
Clinical Epidemiology
Epidemiology
Health Services Research
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BACKGROUND: An improved understanding of racial differences in the natural history, clinical characteristics, and outcomes of heart failure will have important clinical and public health implications. We assessed how clinical characteristics and outcomes vary across racial groups (whites, blacks, and Asians) in adults with heart failure with preserved ejection fraction. METHODS: We identified all adults with heart failure with preserved ejection fraction between 2005 and 2008 from 4 health systems in the Cardiovascular Research Network using hospital principal discharge and ambulatory visit diagnoses. RESULTS: Among 13,437 adults with confirmed heart failure with preserved ejection fraction, 85.9% were white, 7.6% were black, and 6.5% were Asian. After adjustment for potential confounders and use of cardiovascular therapies, compared with whites, blacks (adjusted hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.62-0.85) and Asians (HR, 0.75; 95% CI, 0.64-0.87) had a lower risk of death from any cause. Compared with whites, blacks had a higher risk of hospitalization for heart failure (HR, 1.48; 95% CI, 1.29-1.68); no difference was observed for Asians compared with whites (HR, 1.01; 95% CI, 0.86-1.18). Compared with whites, no significant differences were detected in risk of hospitalization for any cause for blacks (HR, 1.03; 95% CI, 0.95-1.12) and Asians (HR, 0.93; 95% CI, 0.85-1.02). CONCLUSIONS: In a diverse population with heart failure with preserved ejection fraction, we observed complex relationships between race and important clinical outcomes. More detailed studies of large populations are needed to fully characterize the epidemiologic picture and to elucidate potential pathophysiologic and treatment-response differences that may relate to race.Source
Am J Med. 2015 Jun;128(6):591-600. doi: 10.1016/j.amjmed.2014.11.034. Epub 2014 Dec 30. Link to article on publisher's site
DOI
10.1016/j.amjmed.2014.11.034Permanent Link to this Item
http://hdl.handle.net/20.500.14038/37309PubMed ID
25554372Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/j.amjmed.2014.11.034