Dataset Information

Risk factors for incident heart failure in age- and sex-specific strata: a population-based cohort using linked electronic health records.

ABSTRACT:

Aims

Several risk factors for incident heart failure (HF) have been previously identified, however large electronic health records (EHR) datasets may provide the opportunity to examine the consistency of risk factors across different subgroups from the general population.

Methods and results

We used linked EHR data from 2000 to 2010 as part of the UK-based CALIBER resource to select a cohort of 871?687 individuals 55?years or older and free of HF at baseline. The primary endpoint was the first record of HF from primary or secondary care. Cox proportional hazards analysis was used to estimate hazard ratios for associations between risk factors and incident HF, separately for men and women and by age category: 55-64, 65-74, and >?75?years. During 5.8?years of median follow-up, a total of 47?987 incident HF cases were recorded. Age, social deprivation, smoking, sedentary lifestyle, diabetes, atrial fibrillation, chronic obstructive pulmonary disease, body mass index, haemoglobin, total white blood cell count and creatinine were associated with HF. Smoking, atrial fibrillation and diabetes showed stronger associations with incident HF in women compared to men.

Conclusion

We confirmed associations of several risk factors with HF in this large population-based cohort across age and sex subgroups. Mainly modifiable risk factors and comorbidities are strongly associated with incident HF, highlighting the importance of preventive strategies targeting such risk factors for HF.

SUBMITTER: Uijl A

PROVIDER: S-EPMC7074015 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Publications

Risk factors for incident heart failure in age- and sex-specific strata: a population-based cohort using linked electronic health records.

Uijl Alicia A Koudstaal Stefan S Direk Kenan K Denaxas Spiros S Groenwold Rolf H H RHH Banerjee Amitava A Hoes Arno W AW Hemingway Harry H Asselbergs Folkert W FW

European journal of heart failure 20190107 10

<h4>Aims</h4>Several risk factors for incident heart failure (HF) have been previously identified, however large electronic health records (EHR) datasets may provide the opportunity to examine the consistency of risk factors across different subgroups from the general population.<h4>Methods and results</h4>We used linked EHR data from 2000 to 2010 as part of the UK-based CALIBER resource to select a cohort of 871 687 individuals 55 years or older and free of HF at baseline. The primary endpoint ...[more]

PMID: 30618162

Similar Datasets

Project description:ImportanceThe Pooled Cohort Equations to Prevent Heart Failure (PCP-HF) estimate the 10-year risk for symptomatic heart failure (HF) from routine clinical data. The PCP-HF score should detect asymptomatic individuals with cardiac maladaptation preceding HF symptoms for it to be a useful HF prediction tool in primary prevention.ObjectiveTo assess the concordance between PCP-HF risk scoring and the presence of subclinical cardiac maladaptation in the community.Design, setting, and participantsThis cross-sectional analysis included participants enrolled in the Flemish Study on Environment, Genes and Health Outcomes who underwent a clinical examination including echocardiography between May 2005 and January 2015. Participants younger than 30 years, older than 79 years, had prevalent cardiovascular disease, and/or had suboptimal echocardiographic imaging quality were excluded. Analysis began February 2020 and ended April 2020.ExposuresTen-year HF risk as calculated from routine clinical data using the PCP-HF. Based on tertile limits, participants were categorized as having low (≤0.4%), intermediate (0.4%-2.4%), and high (≥2.4%) 10-year HF risk score.Main outcomes and measuresEchocardiographic profiles of subclinical heart remodeling and dysfunction.ResultsA total of 1020 individuals were analyzed (mean [SD] age, 52.8 [11.4] years; 541 female [53.0%]). The prevalence of left ventricular (LV) remodeling and dysfunction was significantly higher from low to intermediate and high 10-year HF risk score. A doubling in 10-year HF risk score was associated with higher odds for LV concentric remodeling (odds ratio [OR], 1.48; 95% CI, 1.36-1.61; P < .001), LV hypertrophy (OR, 1.66; 95% CI, 1.51-1.83; P < .001), abnormal LV longitudinal strain (OR, 1.12; 95% CI, 1.05-1.19; P < .001), and LV diastolic dysfunction (OR, 2.28; 95% CI, 1.94-2.69; P < .001). Moreover, the PCP-HF score detected echocardiographic abnormalities with an accuracy of 74% (LV concentric remodeling), 78% (LV hypertrophy), 59% (abnormal LV longitudinal strain), and 87% (LV diastolic dysfunction). The likelihood of LV concentric remodeling, hypertrophy, and diastolic dysfunction were 3.1, 3.8, and 9.4 times higher in participants with high 10-year HF risk score than the average population risk, respectively (P < .001). Of all PCP-HF score components, age, body mass index, and systolic blood pressure were key correlates of echocardiographic abnormalities in multivariable-adjusted analysis.Conclusions and relevancePCP-HF risk scoring adequately detected individuals with subclinical heart maladaptation that precedes HF symptoms by years. Thus, it may be a valuable HF prediction tool in primary prevention.

Dataset Information

Risk factors for incident heart failure in age- and sex-specific strata: a population-based cohort using linked electronic health records.

Aims

Methods and results

Conclusion

Publications

Risk factors for incident heart failure in age- and sex-specific strata: a population-based cohort using linked electronic health records.

Similar Datasets

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