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A comparison of risk factors for mortality from heart failure in Asian and non-Asian populations: An overview of individual participant data from 32 prospective cohorts from the Asia-Pacific Region

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posted on 2014-01-01, 00:00 authored by Rachel HuxleyRachel Huxley, F Barzi, J Woo, G Giles, T H Lam, K Rahimi, S Konety, T Ohkubo, S H Jee, X Fang, M Woodward, A Okayama, H Ueshima, H Maegawa, M Nakamura, N Aoki, Z S Wu, C H Yao, M Luszcz, T A Welborn, Z Tang, L S Liu, J X Xie, R Norton, S Ameratunga, S MacMahon, G Whitlock, M W Knuiman, H Christensen, X G Wu, J Zhou, X H Yu, A Tamakoshi, W H Pan, Z L Wu, L Q Chen, G L Shan, P Sritara, D F Gu, X F Duan, G.Whitlock, R Jackson, Y H Li, C Q Jiang, Y Kiyohara, H Arima, M Iida, S C Ho, Z Hong, M S Huang, B Zhou, J L Fuh, Y Kita, S R Choudhury, I Suh, I S Kim, T Hashimoto, K Sakata, A Dobson, Y Imai, A Hozawa, K J the late, M Hobbs, R Broadhurst, K Nakachi, X H Fang, S C Li, Q D Yang, Z M Chen, H Tanaka, A Nozaki, H Horibe, Y Matsutani, M Kagaya, K Hughes, J Lee, D Heng, S K Chew, B F Zhou, H Y Zhang, K Shimamoto, S Saitoh, Z Z Li, P Norman, K Jamrozik, Y He, S X Yao
Background: Most of what is known regarding the epidemiology of mortality from heart failure (HF) comes from studies within Western populations with few data available from the Asia-Pacific region where the burden of heart failure is increasing.Methods: Individual level data from 543694 (85% Asian; 36% female) participants from 32 cohorts in the Asia Pacific Cohort Studies Collaboration were included in the analysis. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) for mortality from HF were estimated separately for Asians and non-Asians for a quintet of cardiovascular risk factors: systolic blood pressure, diabetes, body mass index, cigarette smoking and total cholesterol. All analyses were stratified by sex and study.Results: During 3,793,229 person years of follow-up there were 614 HF deaths (80% Asian). The positive associations between elevated blood pressure, obesity, and cigarette smoking were consistent for Asians and non-Asians. There was evidence to indicate that diabetes was a weaker risk factor for death from HF for Asians compared with non-Asians: HR 1.26 (95% CI: 0.74-2.13) versus 3.04 (95% CI 1.76-5.25) respectively; p for interaction = 0.022. Additional adjustment for covariates did not materially change the overall associations. There was no good evidence to indicate that total cholesterol was a risk factor for HF mortality in either population.Conclusions: Most traditional cardiovascular risk factors including elevated blood pressure, obesity and cigarette smoking appear to operate similarly to increase the risk of death from HF in Asians and non-Asians populations alike. © 2014 Huxley et al.; licensee BioMed Central Ltd.



BMC Cardiovascular Disorders



Article number



1 - 10


BioMed Central


London, Eng.





Publication classification

C1 Refereed article in a scholarly journal