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Racial Differences and Temporal Obesity Trends in Heart Failure with Preserved Ejection Fraction.

Publication ,  Journal Article
Caughey, MC; Vaduganathan, M; Arora, S; Qamar, A; Mentz, RJ; Chang, PP; Yancy, CW; Russell, SD; Shah, SJ; Rosamond, WD; Pandey, A
Published in: J Am Geriatr Soc
May 2021

BACKGROUND/OBJECTIVES: Obesity increases with age, is disproportionately prevalent in black populations, and is associated with heart failure with preserved ejection fraction (HFpEF). An "obesity paradox," or improved survival with obesity, has been reported in patients with HFpEF. The aim of this study was to examine whether racial differences exist in the temporal trends and outcomes associated with obesity among older patients with HFpEF. DESIGN: Community surveillance of acute decompensated heart failure (ADHF) hospitalizations, sampled by stratified design from 2005 to 2014. SETTING: Atherosclerosis Risk in Communities Study (NC, MS, MD, MN). PARTICIPANTS: A total of 10,147 weighted hospitalizations for ADHF (64% female, 74% white, mean age 77 years), with ejection fraction ≥50%. MEASUREMENTS: ADHF classified by physician review, HFpEF defined by ejection fraction ≥50%. Body mass index (BMI) calculated from weight at hospital discharge. Obesity defined by BMI ≥30 kg/m2 , class III obesity by BMI ≥40 kg/m2 . RESULTS: When aggregated across 2005-2014, the mean BMI was higher for black compared to white patients (34 vs 30 kg/m2 ; P < .0001), as was prevalence of obesity (56% vs 43%; P < .0001) and class III obesity (24% vs 13%; P < .0001). Over time, the annual mean BMI and prevalence of class III obesity remained stable for black patients, but steadily increased for white patients, with annual rates statistically differing by race (P-interaction = .04 and P = .03, respectively). For both races, a U-shaped adjusted mortality risk was observed across BMI categories, with the highest risk among patients with a BMI ≥40 kg/m2 . CONCLUSION: Black patients were disproportionately burdened by obesity in this decade-long community surveillance of older hospitalized patients with HFpEF. However, temporal increases in mean BMI and class III obesity prevalence among white patients narrowed the racial difference in recent years. For both races, the worst survival was observed with class III obesity. Effective strategies are needed to manage obesity in patients with HFpEF.

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Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

May 2021

Volume

69

Issue

5

Start / End Page

1309 / 1318

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Stroke Volume
  • Race Factors
  • Prevalence
  • Population Surveillance
  • Obesity
  • Male
  • Humans
  • Hospitalization
 

Citation

APA
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Caughey, M. C., Vaduganathan, M., Arora, S., Qamar, A., Mentz, R. J., Chang, P. P., … Pandey, A. (2021). Racial Differences and Temporal Obesity Trends in Heart Failure with Preserved Ejection Fraction. J Am Geriatr Soc, 69(5), 1309–1318. https://doi.org/10.1111/jgs.17004
Caughey, Melissa C., Muthiah Vaduganathan, Sameer Arora, Arman Qamar, Robert J. Mentz, Patricia P. Chang, Clyde W. Yancy, et al. “Racial Differences and Temporal Obesity Trends in Heart Failure with Preserved Ejection Fraction.J Am Geriatr Soc 69, no. 5 (May 2021): 1309–18. https://doi.org/10.1111/jgs.17004.
Caughey MC, Vaduganathan M, Arora S, Qamar A, Mentz RJ, Chang PP, et al. Racial Differences and Temporal Obesity Trends in Heart Failure with Preserved Ejection Fraction. J Am Geriatr Soc. 2021 May;69(5):1309–18.
Caughey, Melissa C., et al. “Racial Differences and Temporal Obesity Trends in Heart Failure with Preserved Ejection Fraction.J Am Geriatr Soc, vol. 69, no. 5, May 2021, pp. 1309–18. Pubmed, doi:10.1111/jgs.17004.
Caughey MC, Vaduganathan M, Arora S, Qamar A, Mentz RJ, Chang PP, Yancy CW, Russell SD, Shah SJ, Rosamond WD, Pandey A. Racial Differences and Temporal Obesity Trends in Heart Failure with Preserved Ejection Fraction. J Am Geriatr Soc. 2021 May;69(5):1309–1318.
Journal cover image

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

May 2021

Volume

69

Issue

5

Start / End Page

1309 / 1318

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Stroke Volume
  • Race Factors
  • Prevalence
  • Population Surveillance
  • Obesity
  • Male
  • Humans
  • Hospitalization