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Left ventricular dysfunction as a risk factor for cardiovascular and noncardiovascular hospitalizations in African Americans.

TitleLeft ventricular dysfunction as a risk factor for cardiovascular and noncardiovascular hospitalizations in African Americans.
Publication TypeJournal Article
Year of Publication2010
AuthorsBlecker S, Matsushita K, Fox E, Russell SD, Miller ER, Taylor H, Brancati F, Coresh J
JournalAm Heart J
Volume160
Issue3
Pagination488-95
Date Published2010 Sep
ISSN1097-6744
KeywordsAfrican Americans, Comorbidity, Diabetic Angiopathies, Female, Hospitalization, Humans, Hypertension, Kaplan-Meier Estimate, Male, Middle Aged, Mississippi, Pulmonary Disease, Chronic Obstructive, Risk Factors, Ultrasonography, Ventricular Dysfunction, Left
Abstract

BACKGROUND: A substantial portion of the public health burden of heart failure is due to hospitalizations, many of which are for causes other than cardiovascular disease. We assessed whether left ventricular (LV) systolic dysfunction was associated with increased risk of both cardiovascular and noncardiovascular hospitalizations in a community sample of African Americans.

METHODS: African American participants from the Jackson, MS, site of the Atherosclerosis Risk in Communities (ARIC) study who underwent echocardiography were followed for 12 years. Hospitalization rates among individuals with and without LV systolic dysfunction were compared using negative binomial regression.

RESULTS: Among 2,416 participants with echocardiograms, LV systolic dysfunction was found in 61 (2.5%). Participants with LV dysfunction experienced 366 hospitalizations, a rate of 1.27 per person-year, compared with 0.25 per person-year among individuals without LV dysfunction. The incidence rate ratio adjusted for demographics, comorbidities, and other risk factors was 3.11 (95% CI 2.22-4.35). The adjusted rate ratios were 4.76 (95% CI 2.90-7.20) for cardiovascular and 2.67 (95% CI 1.82-3.90) for noncardiovascular diagnoses, with similar findings in the subset of individuals with asymptomatic LV dysfunction. The percentage attributable risks for hospitalizations were 87% and 74% for cardiovascular and noncardiovascular causes (79% and 63% after adjustment).

CONCLUSIONS: African American individuals with LV dysfunction are at an increased risk of hospitalization due to a wide range of causes, with noncardiovascular hospitalizations accounting for nearly half the increased risk. To the extent that estimates of risk focus on cardiovascular morbidity, they may underestimate the true health burden of LV dysfunction.

DOI10.1016/j.ahj.2010.06.035
Alternate JournalAm Heart J
PubMed ID20826258
PubMed Central IDPMC2939008
Grant ListUL1RR025005 / RR / NCRR NIH HHS / United States
UL1 RR025005 / RR / NCRR NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
T32 HL007024-36 / HL / NHLBI NIH HHS / United States
N01 HC055015 / HC / NHLBI NIH HHS / United States
K08 HS023683 / HS / AHRQ HHS / United States