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Pooled cohort equations heart failure risk score predicts cardiovascular disease and all-cause mortality in a nationally representative sample of US adults.


ABSTRACT:

Background

Heart failure (HF) represents an accumulated burden of systemic vascular damage and is the fastest growing form of cardiovascular disease (CVD). Due to increasing HF-attributable mortality rates, we sought to assess the association of the new 2019 Pooled Cohort equations to Prevent Heart Failure (PCP-HF) risk score with CVD and all-cause mortality.

Methods

We linked data for 6333 black and white men and women aged 40-79 years, whom underwent electrocardiographic examination from the Third National Health and Nutrition Exam Survey, to National Death Index record matches. Sex- and race-specific PCP-HF risk scores were calculated using data on age, smoking, body mass index, systolic blood pressure, total cholesterol, HDL-cholesterol, fasting blood glucose, QRS complex duration, and antihypertensive and/or glucose-lowering medications. Cox regression estimated hazard ratios for the association of the PCP-HF risk score with CVD and all-cause mortality.

Results

Individuals were on average 54.9 years old (51.7% women, 25.4% black) and the median 10-year HF risk was 1.6% (Q1 = 0.5, Q3 = 4.8). There were 3178 deaths, 1116 from CVD, over a median follow-up time of 22.3 years. Black women had a higher 10-year HF risk compared to white women (2.1% vs. 1.1%; p < 0.01), while no significant difference was observed in predicted HF risk between black men and white men (2.3% vs. 2.1%, p = 0.16). A two-fold higher PCP-HF risk score was associated with a significant 58% (HR = 1.58; 95% CI, 1.48-1.70; p < 0.0001) and 38% (HR = 1.38; 95% CI, 1.32-1.46; p < 0.0001) greater risk of CVD and all-cause mortality, respectively.

Conclusion

The PCP-HF risk score predicts CVD and all-cause mortality, in addition to the 10-year risk of incident HF among white and black men and women. These results underline the expanded utility of the PCP-HF risk score and suggest that its implementation in the clinical and population health settings may improve primary CVD prevention in the United States.

SUBMITTER: Razavi AC 

PROVIDER: S-EPMC7183589 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Publications

Pooled cohort equations heart failure risk score predicts cardiovascular disease and all-cause mortality in a nationally representative sample of US adults.

Razavi Alexander C AC   Potts Kaitlin S KS   Kelly Tanika N TN   He Jiang J   Fernandez Camilo C   Krousel-Wood Marie M   Anderson Amanda H AH   Bundy Joshua J   Whelton Seamus P SP   Blumenthal Roger S RS   Lloyd-Jones Donald D   Bazzano Lydia A LA  

BMC cardiovascular disorders 20200425 1


<h4>Background</h4>Heart failure (HF) represents an accumulated burden of systemic vascular damage and is the fastest growing form of cardiovascular disease (CVD). Due to increasing HF-attributable mortality rates, we sought to assess the association of the new 2019 Pooled Cohort equations to Prevent Heart Failure (PCP-HF) risk score with CVD and all-cause mortality.<h4>Methods</h4>We linked data for 6333 black and white men and women aged 40-79 years, whom underwent electrocardiographic examina  ...[more]

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