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Race, Gender, and Mortality in Adults >65 Years of Age With Incident Heart Failure (from the Cardiovascular Health Study)
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| 03.05.2009, 14:55 |
In patients with heart failure (HF), mortality is lower in women versus men. However, it
is unknown whether the survival advantage in women compared with men is present in
both whites and African Americans with HF. The inception cohort consisted of adults >65
years with incident HF after enrollment in the CHS, a prospective population-based study
of cardiovascular disease. Of 5,888 CHS subjects, 1,264 developed new HF and were
followed up for 3 years. Subjects were categorized into 4 race-gender groups, and Cox
proportional hazard regression models were used to examine whether 3-year total and
cardiovascular mortality differed among the 4 groups after adjusting for sociodemographic
factors, co-morbidities, and treatment. A gender-race interaction was also tested for each
outcome. In subjects with incident HF, African Americans had more hypertension and
diabetes than whites, and white men had more coronary heart disease than other genderrace
groups. Receipt of cardiovascular treatments among the 4 groups was similar. Mortality
rates after HF were lower in women compared with men (for white women, African-
American women, African-American men, and white men, total mortality was 35.5, 33.6,
44.4, and 40.5/100 person-years, and cardiovascular mortality was 18.4, 19.5, 20.2, and
22.7/100 person-years, respectively). After adjusting for covariates, women had a 15% to
20% lower risk of total and cardiovascular mortality compared with men, but there was no
significant difference in outcome by race. The gender-race interaction for either outcome
was not significant. In conclusion, in older adults with HF, women had significantly better
survival than men irrespective of race, suggesting that gender-based survival differences
may be more important than race-based differences. © 2009 Elsevier Inc. (Am J Cardiol
2009;103:1120 –1127)
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| Категория: Статьи | Добавил: nbylova
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