Sex-Specific Epidemiology of Heart Failure Risk and Mortality in Europe: Results From the BiomarCaRE Consortium.

Adult Aged Aged, 80 and over Alcohol Drinking / epidemiology Blood Pressure C-Reactive Protein / metabolism Cohort Studies Europe / epidemiology Female Heart Failure / epidemiology Heart Rate Humans Hypertension / epidemiology Incidence Male Middle Aged Myocardial Infarction / epidemiology Natriuretic Peptide, Brain / metabolism Peptide Fragments / metabolism Proportional Hazards Models Prospective Studies Risk Factors Sex Distribution Sex Factors Smoking / epidemiology Stroke / epidemiology Systole Young Adult

biomarkers cohort epidemiology heart failure mortality sex

Journal

JACC. Heart failure

ISSN: 2213-1787

Titre abrégé: JACC Heart Fail

Pays: United States

ID NLM: 101598241

Informations de publication

Date de publication:
03 2019

Historique:

received: 03 05 2018

revised: 13 08 2018

accepted: 28 08 2018

entrez: 2 3 2019

pubmed: 2 3 2019

medline: 2 7 2020

Statut: ppublish

Résumé

This study investigates differences between women and men in heart failure (HF) risk and mortality. Sex differences in HF epidemiology are insufficiently understood. In 78,657 individuals (median 49.5 years of age; age range 24.1 to 98.7 years; 51.7% women) from community-based European studies (FINRISK, DanMONICA, Moli-sani, Northern Sweden) of the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium, the association between incident HF and mortality, the relationship of cardiovascular risk factors, prevalent cardiovascular diseases, biomarkers (C-reactive protein [CRP]; N-terminal pro-B-type natriuretic peptide [NT-proBNP]) with incident HF, and their attributable risks were tested in women vs. men. Over a median follow-up of 12.7 years, fewer HF cases were observed in women (n = 2,399 [5.9%]) than in men (n = 2,771 [7.3%]). HF incidence increased markedly after 60 years of age, initially with a more rapid increase in men, whereas incidence in women exceeded that of men after 85 years of age. HF onset substantially increased mortality risk in both sexes. Multivariable-adjusted Cox models showed the following sex differences for the association with incident HF: systolic blood pressure hazard ratio (HR) according to SD in women of 1.09 (95% confidence interval [CI]: 1.05 to 1.14) versus HR of 1.19 (95% CI: 1.14 to 1.24) in men; heart rate HR of 0.98 (95% CI: 0.93 to 1.03) in women versus HR of 1.09 (95% CI: 1.04 to 1.13) in men; CRP HR of 1.10 (95% CI: 1.00 to 1.20) in women versus HR of 1.32 (95% CI: 1.24 to 1.41) in men; and NT-proBNP HR of 1.54 (95% CI: 1.37 to 1.74) in women versus HR of 1.89 (95% CI: 1.75 to 2.05) in men. Population-attributable risk of all risk factors combined was 59.0% in women and 62.9% in men. Women had a lower risk for HF than men. Sex differences were seen for systolic blood pressure, heart rate, CRP, and NT-proBNP, with a lower HF risk in women.

Sections du résumé

OBJECTIVES

This study investigates differences between women and men in heart failure (HF) risk and mortality.

BACKGROUND

Sex differences in HF epidemiology are insufficiently understood.

METHODS

In 78,657 individuals (median 49.5 years of age; age range 24.1 to 98.7 years; 51.7% women) from community-based European studies (FINRISK, DanMONICA, Moli-sani, Northern Sweden) of the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium, the association between incident HF and mortality, the relationship of cardiovascular risk factors, prevalent cardiovascular diseases, biomarkers (C-reactive protein [CRP]; N-terminal pro-B-type natriuretic peptide [NT-proBNP]) with incident HF, and their attributable risks were tested in women vs. men.

RESULTS

Over a median follow-up of 12.7 years, fewer HF cases were observed in women (n = 2,399 [5.9%]) than in men (n = 2,771 [7.3%]). HF incidence increased markedly after 60 years of age, initially with a more rapid increase in men, whereas incidence in women exceeded that of men after 85 years of age. HF onset substantially increased mortality risk in both sexes. Multivariable-adjusted Cox models showed the following sex differences for the association with incident HF: systolic blood pressure hazard ratio (HR) according to SD in women of 1.09 (95% confidence interval [CI]: 1.05 to 1.14) versus HR of 1.19 (95% CI: 1.14 to 1.24) in men; heart rate HR of 0.98 (95% CI: 0.93 to 1.03) in women versus HR of 1.09 (95% CI: 1.04 to 1.13) in men; CRP HR of 1.10 (95% CI: 1.00 to 1.20) in women versus HR of 1.32 (95% CI: 1.24 to 1.41) in men; and NT-proBNP HR of 1.54 (95% CI: 1.37 to 1.74) in women versus HR of 1.89 (95% CI: 1.75 to 2.05) in men. Population-attributable risk of all risk factors combined was 59.0% in women and 62.9% in men.

CONCLUSIONS

Women had a lower risk for HF than men. Sex differences were seen for systolic blood pressure, heart rate, CRP, and NT-proBNP, with a lower HF risk in women.

Identifiants

DOI: 10.1016/j.jchf.2018.08.008 PMID: 30819375

pubmed: 30819375

pii: S2213-1779(18)30690-5

doi: 10.1016/j.jchf.2018.08.008

pii:

doi:

Substances chimiques

Peptide Fragments 0

pro-brain natriuretic peptide (1-76) 0

Natriuretic Peptide, Brain 114471-18-0

C-Reactive Protein 9007-41-4

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

204-213

Commentaires et corrections

Type : CommentIn