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Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis

Hossein Bahrami1, Richard Kronmal, David A Bluemke

  • 1Division of Cardiology, Department of Medicine, The Johns Hopkins University, Baltimore, MD 21287, USA.

Archives of Internal Medicine
|October 29, 2008
PubMed

Insights

African Americans face a higher risk of congestive heart failure (CHF), primarily due to hypertension and diabetes. Mechanisms of CHF also vary by ethnicity, with myocardial infarction being less influential in African Americans.

Area of Science:

  • Cardiovascular epidemiology
  • Population health disparities
  • Clinical outcomes research

Background:

  • Limited understanding of ethnic variations in congestive heart failure (CHF) incidence and mechanisms.
  • Need for multiracial, population-based research to clarify racial/ethnic differences in CHF development.

Purpose of the Study:

  • To investigate the relationship between race/ethnicity and the incidence of congestive heart failure (CHF).
  • To explore ethnic differences in the underlying mechanisms contributing to CHF.

Main Methods:

  • Utilized data from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort (N=6814).
  • Excluded participants with pre-existing cardiovascular disease.
  • Employed Cox proportional hazards models to analyze incident CHF rates across four ethnicities: white, African American, Hispanic, and Chinese American.

Main Results:

  • African Americans exhibited the highest CHF incidence rate (4.6 per 1000 person-years), followed by Hispanic, white, and Chinese American participants.
  • The elevated CHF risk in African Americans was attenuated when hypertension and diabetes mellitus were included in the models.
  • African Americans had a higher proportion of CHF cases not preceded by myocardial infarction (75%).

Conclusions:

  • Higher congestive heart failure (CHF) risk in African Americans is linked to disparities in hypertension, diabetes mellitus, and socioeconomic status.
  • Distinct pathophysiological pathways for CHF exist across ethnic groups, with left ventricular mass increase being significant in Hispanic and white participants.
Abstract

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