Details:

• Alternative Title:
  Circ Cardiovasc Qual Outcomes
• Personal Author:
  Malla, Gargya ; Long, D. Leann ; Cherrington, Andrea ; Goyal, Parag ; Guo, Boyi ; ... More +

  Malla, Gargya ; Long, D. Leann ; Cherrington, Andrea ; Goyal, Parag ; Guo, Boyi ; Safford, Monika M. ; Khodneva, Yulia ; Cummings, Doyle M. ; McAlexander, Tara P. ; DeSilva, Shanika ; Judd, Suzanne E. ; Hidalgo, Bertha ; Levitan, Emily B. ; Carson, April P. Less -
• Description:
  Background:
  
  Heart failure (HF) affects >6 million US adults, with recent increases in HF hospitalizations. We aimed to investigate the association between neighborhood disadvantage and incident HF events and potential differences by diabetes status.
  
  Methods:
  
  We included 23,645 participants from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a prospective cohort of Black and White adults age ≥45 years living in the continental US. Neighborhood disadvantage was assessed using a z-score of 6 census-tract variables (2000 US Census) and categorized as quartiles. Incident HF hospitalizations or HF related deaths through 2017 were adjudicated. Multivariable adjusted Cox regression was used to examine the association between neighborhood disadvantage and incident HF. Heterogeneity by diabetes was assessed using an interaction term.
  
  Results:
  
  The mean age was 64.4 years, 39.5% were Black adults, 54.9% females, and 18.8% had diabetes. During a median follow-up of 10.7 years, there were 1125 incident HF events with an incidence rate of 3.3 (quartile 1), 4.7 (quartile 2), 5.2 (quartile 3), and 6.0 (quartile 4) per 1000 person-years. Compared to adults living in the most advantaged neighborhoods (quartile 1), those living in neighborhoods in quartiles 2, 3 and 4 (most disadvantaged) had 1.30 (95%CI=1.06-1.60), 1.36 (95%CI=1.11-1.66) and 1.45 (95%CI=1.18-1.79) times greater hazard of incident HF even after accounting for known confounders. This association did not significantly differ by diabetes status (interaction p=0.59). For adults with diabetes, the adjusted incident HF hazards comparing those in quartile 4 vs quartile 1 was 1.34 (95%CI=0.92-1.96) and it was 1.50 (95%CI=1.16-1.94) for adult without diabetes.
  
  Conclusion:
  
  In this large contemporaneous prospective cohort, neighborhood disadvantage was associated with increased risk of incident HF events. This increase in HF risk did not differ by diabetes status. Addressing social, economic and structural factors at the neighborhood level may impact HF prevention.
  
  
• Subjects:
  [+]

  Adult Diabetes Mellitus Female Heart Failure Humans Incidence Male Middle Aged Neighborhood Characteristics Prospective Studies Race Factors Risk Factors Stroke United States
• Keywords:
  [+]

  Neighborhood Disadvantage
• Source:
  Circ Cardiovasc Qual Outcomes. 17(3):e009867
• Pubmed ID:
  38328917
• Pubmed Central ID:
  PMC10950536
• Document Type:
  Journal Article
• Funding:
  U01DP006302/ACL/ACL HHSUnited States/ ; R01 HL080477/HL/NHLBI NIH HHSUnited States/ ; R01 HL165452/HL/NHLBI NIH HHSUnited States/ ; U01 NS041588/NS/NINDS NIH HHSUnited States/ ; U01 DP006302/DP/NCCDPHP CDC HHSUnited States/

  U01DP006302/ACL/ACL HHSUnited States/ ; R01 HL080477/HL/NHLBI NIH HHSUnited States/ ; R01 HL165452/HL/NHLBI NIH HHSUnited States/ ; U01 NS041588/NS/NINDS NIH HHSUnited States/ ; U01 DP006302/DP/NCCDPHP CDC HHSUnited States/ Less -
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  [+]

  urn:sha256:7d89135f1bddb5ca19a16285eebe26a446946f9370beb8bff86bd6452181629f
• File Type:

• Supporting Files:
  No Additional Files