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Health Status Disparities by Sex, Race/Ethnicity, and Socioeconomic Status in Outpatients With Heart Failure.

Publication ,  Journal Article
Khariton, Y; Nassif, ME; Thomas, L; Fonarow, GC; Mi, X; DeVore, AD; Duffy, C; Sharma, PP; Albert, NM; Patterson, JH; Butler, J; Hernandez, AF ...
Published in: JACC Heart Fail
June 2018

OBJECTIVES: This study sought to describe the health status of outpatients with heart failure and reduced ejection fraction (HFrEF) by sex, race/ethnicity, and socioeconomic status (SES). BACKGROUND: Although a primary goal in treating patients with HFrEF is to optimize health status, whether disparities by sex, race/ethnicity, and SES exist is unknown. METHODS: In the CHAMP-HF (Change the Management of Patients with Heart Failure) registry, the associations among sex, race, and SES and health status, as measured by the Kansas City Cardiomyopathy Questionnaire-overall summary (KCCQ-os) score (range 0 to 100; higher scores indicate better health status) was compared among 3,494 patients from 140 U.S. clinics. SES was categorized by total household income. Hierarchical multivariate linear regression estimated differences in KCCQ-os score after adjusting for 31 patient characteristics and 10 medications. RESULTS: Overall mean KCCQ-os scores were 64.2 ± 24.0 but lower for women (29% of sample; 60.3 ± 24.0 vs. 65.9 ± 24.0, respectively; p < 0.001), for blacks (60.5 ± 25.0 vs. 64.9 ± 23.0, respectively; p < 0.001), for Hispanics (59.1 ± 21.0 vs. 64.9 ± 23.0, respectively; p < 0.001), and for those with the lowest income (<$25,000; mean: 57.1 vs. 63.1 to 74.7 for other income categories; p < 0.001). Fully adjusted KCCQ-os scores were 2.2 points lower for women (95% confidence interval [CI]: -3.8 to -0.6; p = 0.007), no different for blacks (p = 0.74), 4.0 points lower for Hispanics (95% CI: -6.6 to -1.3; p = 0.003), and lowest in the poorest patients (4.7 points lower than those with the highest income (95% CI: 0.1 to 9.2; p = 0.045; p for trend = 0.003). CONCLUSIONS: Among outpatients with HFrEF, women, blacks, Hispanics, and poorer patients had worse health status, which remained significant for women, Hispanics, and poorer patients in fully adjusted analyses. This suggests an opportunity to further optimize treatment to reduce these observed disparities.

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Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

June 2018

Volume

6

Issue

6

Start / End Page

465 / 473

Location

United States

Related Subject Headings

  • United States
  • Social Class
  • Sex Factors
  • Registries
  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Hispanic or Latino
  • Heart Failure
 

Citation

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Chicago
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Khariton, Y., Nassif, M. E., Thomas, L., Fonarow, G. C., Mi, X., DeVore, A. D., … Spertus, J. A. (2018). Health Status Disparities by Sex, Race/Ethnicity, and Socioeconomic Status in Outpatients With Heart Failure. JACC Heart Fail, 6(6), 465–473. https://doi.org/10.1016/j.jchf.2018.02.002
Khariton, Yevgeniy, Michael E. Nassif, Laine Thomas, Gregg C. Fonarow, Xiaojuan Mi, Adam D. DeVore, Carol Duffy, et al. “Health Status Disparities by Sex, Race/Ethnicity, and Socioeconomic Status in Outpatients With Heart Failure.JACC Heart Fail 6, no. 6 (June 2018): 465–73. https://doi.org/10.1016/j.jchf.2018.02.002.
Khariton Y, Nassif ME, Thomas L, Fonarow GC, Mi X, DeVore AD, et al. Health Status Disparities by Sex, Race/Ethnicity, and Socioeconomic Status in Outpatients With Heart Failure. JACC Heart Fail. 2018 Jun;6(6):465–73.
Khariton, Yevgeniy, et al. “Health Status Disparities by Sex, Race/Ethnicity, and Socioeconomic Status in Outpatients With Heart Failure.JACC Heart Fail, vol. 6, no. 6, June 2018, pp. 465–73. Pubmed, doi:10.1016/j.jchf.2018.02.002.
Khariton Y, Nassif ME, Thomas L, Fonarow GC, Mi X, DeVore AD, Duffy C, Sharma PP, Albert NM, Patterson JH, Butler J, Hernandez AF, Williams FB, McCague K, Spertus JA. Health Status Disparities by Sex, Race/Ethnicity, and Socioeconomic Status in Outpatients With Heart Failure. JACC Heart Fail. 2018 Jun;6(6):465–473.
Journal cover image

Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

June 2018

Volume

6

Issue

6

Start / End Page

465 / 473

Location

United States

Related Subject Headings

  • United States
  • Social Class
  • Sex Factors
  • Registries
  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Hispanic or Latino
  • Heart Failure