Citation
Avery, Christy L.; Loehr, Laura R.; Baggett, Christopher D.; Chang, Patricia P.; Kucharska-Newton, Anna M.; Matsushita, Kunihiro; Rosamond, Wayne D.; & Heiss, Gerardo M. (2012). The Population Burden of Heart Failure Attributable to Modifiable Risk Factors: The ARIC (Atherosclerosis Risk in Communities) Study. Journal of the American College of Cardiology, 60(17), 1640-1646. PMCID: PMC3653309Abstract
OBJECTIVES: The goal of this study was to estimate the population burden of heart failure and the influence of modifiable risk factors.BACKGROUND: Heart failure is a common, costly, and fatal disorder, yet few studies have evaluated the population-level influence of modifiable risk factors.
METHODS: From 14,709 ARIC (Atherosclerosis Risk in Communities) study participants, we estimated incidence rate differences (IRD) for the association between 5 modifiable risk factors (cigarette smoking, diabetes, elevated low-density lipoproteins, hypertension, and obesity) and heart failure. Potential impact fractions were used to measure expected changes in the heart failure incidence assuming achievement of a 5% proportional decrement in the prevalence of each risk factor.
RESULTS: Over an average of 17.6 years of follow-up, 1 in 3 African American and 1 in 4 Caucasian participants were hospitalized with heart failure, defined as the first hospitalization with International Classification of Diseases, Ninth Revision discharge codes of 428.x. Of the 5 modifiable risk factors, the largest IRD was observed for diabetes, which was associated with 1,058 (95% confidence interval [CI]: 787 to 1,329) and 660 (95% CI: 514 to 805) incident hospitalizations of heart failure/100,000 person-years among African-American and Caucasian participants, respectively. A 5% proportional reduction in the prevalence of diabetes would result in approximately 53 and 33 fewer incident heart failure hospitalizations per 100,000 person-years in African-American and Caucasian ARIC participants, respectively. When applied to U.S. populations, this reduction may prevent approximately 30,000 incident cases of heart failure annually.
CONCLUSIONS: Modest decrements in the prevalence of modifiable heart failure risk factors such as diabetes may substantially decrease the incidence of this major disease.
URL
http://dx.doi.org/10.1016/j.jacc.2012.07.022Reference Type
Journal ArticleYear Published
2012Journal Title
Journal of the American College of CardiologyAuthor(s)
Avery, Christy L.Loehr, Laura R.
Baggett, Christopher D.
Chang, Patricia P.
Kucharska-Newton, Anna M.
Matsushita, Kunihiro
Rosamond, Wayne D.
Heiss, Gerardo M.