In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 139, No. Suppl_1 ( 2019-03-05)
Abstract:
Background: Diabetes, obesity and metabolic syndrome (MS) are strong risk factors for incident heart failure (HF). Lower socioeconomic status (SES) is also linked to increased HF risk. Given the importance of lifestyle, self-management, and access to care in managing diabetes, MS and obesity, SES may confer greater risk among individuals with these conditions. Hypothesis: We hypothesized that lower SES is associated with greater risk for incident HF among individuals with diabetes, MS or obesity than among those without these conditions. Methods: We studied 12,938 ARIC participants (mean age: 53 years, 26% black, 56% female) from the baseline visit (1987-1989) without CVD and with BMI ≥18.5 kg/m 2 . Income, education, and area deprivation index were evaluated as single measures of SES and in a combined SES score (high, medium, low). We constructed Cox regression models to estimate hazard ratios (HRs) for HF associated with SES (through 12/31/16), stratified by diabetes, MS, and obesity status, separately, and with tests for interactions of SES with diabetes, MS or obesity. Results: There were 2,551 HF events over a median 27 years of follow-up. The lowest education level was more strongly associated with HF risk in the presence of diabetes (HR 3.17, 95% CI: 1.95-5.14), than in the absence of diabetes (HR 1.56, 95% CI: 1.31-1.86; p interaction 〈 0.01)(Table). Significant interactions were also observed for diabetes and MS with most other SES measures, including the combined SES score. The combination of lowest education and diabetes was associated with an HR of 3.95 (3.21-4.87) for HF compared to the combination of highest education and no diabetes. There were no significant interactions between obesity and SES measures. Conclusion: Low SES is associated with elevated HF risk, particularly among individuals with diabetes and MS. There is urgent need to understand the underlying mechanisms for this association, which may inform tailored interventions to address the marked HF risk in those with both low SES and diabetes or MS.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.139.suppl_1.MP19
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
detail.hit.zdb_id:
1466401-X
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