Heart failureA Propensity-Matched Study of the Association of Diabetes Mellitus With Incident Heart Failure and Mortality Among Community-Dwelling Older Adults
Section snippets
Methods
The Cardiovascular Health Study (CHS) is a National Heart, Lung, and Blood Institute–funded prospective study designed to assess traditional and nontraditional cardiovascular risk factors in community-dwelling older adults.8 The CHS recruited 5,888 Medicare-eligible community-dwelling adults ≥65 years of age from 4 United States communities in 2 phases. A mostly white initial cohort of 5,201 participants (1989 through 1990) was later supplemented by 687 African-Americans from 3 of those 4
Results
Our matched cohort had a mean age ± SD of 73 ± 6 years, 51% were women, and 21% were African-American (Table 1). Before matching, participants with DM were more likely to have a history of coronary artery disease, hypertension, and stroke and higher mean serum insulin, triglyceride, interleukin-6, and C-reactive protein levels. These and other imbalances were balanced in the matched cohort (Figure 1, Table 1).
Incident HF occurred in 31% and 26% of matched participants with and without DM,
Discussion
Findings from the present propensity-matched study of community-dwelling older adults demonstrate that DM had a strong association with incident HF and all-cause mortality, and these associations were independent of most traditional and nontraditional cardiovascular risk factors at baseline. Results from the present study also demonstrate that the higher incidence of HF in those with DM was due in large part to a higher incidence of AMI in those subjects. In contrast to previous studies of the
Acknowledgment
The CHS was conducted and supported by the National Heart, Lung, and Blood Institute in collaboration with the CHS Investigators. This report was prepared using a limited-access dataset obtained by the National Heart, Lung, and Blood Institute and does not necessarily reflect the opinions or views of the CHS or the National Heart, Lung, and Blood Institute.
References (40)
- et al.
Role of diabetes in congestive heart failure: the Framingham study
Am J Cardiol
(1974) - et al.
Predictors of congestive heart failure in the elderly: the Cardiovascular Health Study
J Am Coll Cardiol
(2000) Confounding: regression adjustment
Nutrition
(2006)- et al.
The Cardiovascular Health Study: design and rationale
Ann Epidemiol
(1991) - et al.
Methods of assessing prevalent cardiovascular disease in the Cardiovascular Health Study
Ann Epidemiol
(1995) - et al.
Surveillance and ascertainment of cardiovascular eventsThe Cardiovascular Health Study
Ann Epidemiol
(1995) - et al.
A propensity-matched study of the association of cardiothoracic ratio with morbidity and mortality in chronic heart failure
Am J Cardiol
(2008) A propensity matched study of New York Heart Association class and natural history end points in heart failure
Am J Cardiol
(2007)- et al.
Chronic kidney disease associated mortality in diastolic versus systolic heart failure: a propensity matched study
Am J Cardiol
(2007) - et al.
A propensity-matched study of hypertension and increased stroke-related hospitalization in chronic heart failure
Am J Cardiol
(2008)
A propensity-matched study of elevated jugular venous pressure and outcomes in chronic heart failure
Am J Cardiol
A propensity-matched study of the association of peripheral arterial disease with cardiovascular outcomes in community-dwelling older adults
Am J Cardiol
Multimorbidity due to diabetes mellitus and chronic kidney disease and outcomes in chronic heart failure
Am J Cardiol
Digoxin and reduction of heart failure hospitalization in chronic systolic and diastolic heart failure
Am J Cardiol
Relation of baseline systolic blood pressure and long-term outcomes in ambulatory patients with chronic mild to moderate heart failure
Am J Cardiol
Warfarin use and outcomes in patients with advanced chronic systolic heart failure without atrial fibrillation, prior thromboembolic events, or prosthetic valves
Am J Cardiol
Effect of serum insulin on the association between hyperuricemia and incident heart failure
Am J Cardiol
Impact of baseline systolic blood pressure on long-term outcomes in patients with advanced chronic systolic heart failure (insights from the BEST trial)
Am J Cardiol
A history of systemic hypertension and incident heart failure hospitalization in patients with acute myocardial infarction and left ventricular systolic dysfunction
Am J Cardiol
Validating recommendations for coronary angiography following acute myocardial infarction in the elderly: a matched analysis using propensity scores
J Clin Epidemiol
Cited by (0)
Dr. Ahmed is supported by the National Institutes of Health, Bethesda, Maryland through Grants R01-HL085561 and R01-HL097047 from the National Heart, Lung, and Blood Institute, Bethesda and a generous gift from Ms. Jean B. Morris of Birmingham, Alabama.