Racial Differences and Temporal Obesity Trends in Heart Failure with Preserved Ejection Fraction.
Black or African American
/ statistics & numerical data
Aged
Aged, 80 and over
Body Mass Index
Female
Health Status Disparities
Heart Failure
/ epidemiology
Hospitalization
/ statistics & numerical data
Humans
Male
Obesity
/ epidemiology
Population Surveillance
Prevalence
Race Factors
/ statistics & numerical data
Stroke Volume
Time Factors
United States
/ epidemiology
epidemiology
heart failure with preserved ejection fraction
obesity
race
surveillance
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
13
11
2020
received:
19
10
2020
accepted:
06
12
2020
pubmed:
6
1
2021
medline:
29
9
2021
entrez:
5
1
2021
Statut:
ppublish
Résumé
Obesity increases with age, is disproportionately prevalent in black populations, and is associated with heart failure with preserved ejection fraction (HFpEF). An "obesity paradox," or improved survival with obesity, has been reported in patients with HFpEF. The aim of this study was to examine whether racial differences exist in the temporal trends and outcomes associated with obesity among older patients with HFpEF. Community surveillance of acute decompensated heart failure (ADHF) hospitalizations, sampled by stratified design from 2005 to 2014. Atherosclerosis Risk in Communities Study (NC, MS, MD, MN). A total of 10,147 weighted hospitalizations for ADHF (64% female, 74% white, mean age 77 years), with ejection fraction ≥50%. ADHF classified by physician review, HFpEF defined by ejection fraction ≥50%. Body mass index (BMI) calculated from weight at hospital discharge. Obesity defined by BMI ≥30 kg/m When aggregated across 2005-2014, the mean BMI was higher for black compared to white patients (34 vs 30 kg/m Black patients were disproportionately burdened by obesity in this decade-long community surveillance of older hospitalized patients with HFpEF. However, temporal increases in mean BMI and class III obesity prevalence among white patients narrowed the racial difference in recent years. For both races, the worst survival was observed with class III obesity. Effective strategies are needed to manage obesity in patients with HFpEF.
Sections du résumé
BACKGROUND/OBJECTIVES
Obesity increases with age, is disproportionately prevalent in black populations, and is associated with heart failure with preserved ejection fraction (HFpEF). An "obesity paradox," or improved survival with obesity, has been reported in patients with HFpEF. The aim of this study was to examine whether racial differences exist in the temporal trends and outcomes associated with obesity among older patients with HFpEF.
DESIGN
Community surveillance of acute decompensated heart failure (ADHF) hospitalizations, sampled by stratified design from 2005 to 2014.
SETTING
Atherosclerosis Risk in Communities Study (NC, MS, MD, MN).
PARTICIPANTS
A total of 10,147 weighted hospitalizations for ADHF (64% female, 74% white, mean age 77 years), with ejection fraction ≥50%.
MEASUREMENTS
ADHF classified by physician review, HFpEF defined by ejection fraction ≥50%. Body mass index (BMI) calculated from weight at hospital discharge. Obesity defined by BMI ≥30 kg/m
RESULTS
When aggregated across 2005-2014, the mean BMI was higher for black compared to white patients (34 vs 30 kg/m
CONCLUSION
Black patients were disproportionately burdened by obesity in this decade-long community surveillance of older hospitalized patients with HFpEF. However, temporal increases in mean BMI and class III obesity prevalence among white patients narrowed the racial difference in recent years. For both races, the worst survival was observed with class III obesity. Effective strategies are needed to manage obesity in patients with HFpEF.
Identifiants
pubmed: 33401338
doi: 10.1111/jgs.17004
pmc: PMC8286810
mid: NIHMS1715622
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1309-1318Subventions
Organisme : NIA NIH HHS
ID : 1R03AG067960-01
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL140731
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL149423
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG045551
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700004C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700003I
Pays : United States
Organisme : NIA NIH HHS
ID : R03 AG067960
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL127028
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL125511
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700002C
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL107577
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700001I
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002541
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700004I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700005C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700001C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700003C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700002I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700005I
Pays : United States
Informations de copyright
© 2021 The American Geriatrics Society.
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