scholarly journals Death of a child and the risk of heart failure: a population‐based cohort study from Denmark and Sweden

2021 ◽  
Author(s):  
Dang Wei ◽  
Jiong Li ◽  
Imre Janszky ◽  
Hua Chen ◽  
Fang Fang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Population Based ◽  
Death Of A Child

scholarly journals Heart Failure Is a Clinically and Densitometrically Independent Risk Factor for Osteoporotic Fractures: Population-Based Cohort Study of 45,509 Subjects

2012 ◽  
Vol 97 (4) ◽  
pp. 1179-1186 ◽  
Author(s):  
Sumit R. Majumdar ◽  
Justin A. Ezekowitz ◽  
Lisa M. Lix ◽  
William D. Leslie
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cohort Study ◽  
Osteoporotic Fractures ◽  
Population Based ◽  
Recent Onset ◽  
Major Osteoporotic Fractures ◽  
Hip Bmd ◽  
Osteoporosis Risk Factors ◽  
Osteoporosis Risk

Objective: The aim of the study was to determine whether heart failure is associated with an increased risk of major osteoporotic fractures that is independent of bone mineral density (BMD). Methods: We conducted a population-based cohort study in Manitoba, Canada, by linking a clinical registry of all adults 50 yr of age and older who underwent initial BMD testing from 1998–2009 with administrative databases. We collected osteoporosis risk factors, comorbidities, medications, and BMD results. Validated algorithms identified recent-onset heart failure before the BMD test and new fractures after. The main outcome was time to major osteoporotic fractures (i.e. clinical vertebrae, distal forearm, humerus, and hip), and multivariable proportional hazards models were used for analyses. Results: The cohort consisted of 45,509 adults; 1,841 (4%) had recent-onset heart failure. Subjects with heart failure were significantly (P < 0.001) older (74 vs. 66 yr) and had more previous fractures (21 vs. 13%) and lower total hip BMD [T-score, −1.3 (sd 1.3) vs. −0.9 (sd 1.2)] than those without. There were 2703 incident fractures over the 5-yr observation. Overall, 10% of heart failure subjects had incident major fractures compared with 5% of those without [unadjusted hazard ratio (HR), 2.45; 95% confidence interval (CI), 2.11–2.85]. Adjustment for osteoporosis risk factors, comorbidities, and medications attenuated but did not eliminate this association (HR, 1.33; 95% CI, 1.11–1.60), nor did further adjustment for total hip BMD (HR, 1.28; 95% CI, 1.06–1.53). Conclusions: Heart failure is associated with a 30% increase in major fractures that is independent of traditional risk factors and BMD, and it also identifies a high-risk population that may benefit from increased screening and treatment for osteoporosis.

scholarly journals P0154BLOOD PRESSURE CONTROL IN ELDERLY PATIENTS WITH HEART FAILURE AND MORTALITY RISK: A POPULATION-BASED PROSPECTIVE COHORT STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Antonios Douros ◽  
Alice Schneider ◽  
Dörte Huscher ◽  
Natalie Ebert ◽  
Nina Mielke ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
High Risk ◽  
Elderly Patients ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Antihypertensive Drugs ◽  
Population Based ◽  
Vulnerable Population ◽  
All Cause Mortality

Abstract Background and Aims Current guidelines on the management of heart failure (HF) recommend control of blood pressure (BP) in elderly patients. However, the exact treatment goals in this vulnerable population are unclear. Thus, our population-based prospective cohort study aimed to assess whether BP values <140/90 mmHg are associated with a decreased risk of cardiovascular (CV) death and all-cause mortality in HF patients ≥70 years. Method The study included participants of the Berlin Initiative Study (BIS), all ≥70 years, who were treated with antihypertensive drugs and had a diagnosis of HF (ICD-10 codes: I11.0, I13.0, I13.2, I50.x) at baseline. The study period was from 2009 to 2017. Demographics, lifestyle factors, medications, and comorbidities were assessed in face-to-face interviews and from linked administrative healthcare data. Outcomes were adjudicated using death certificates and hospital discharge notes. Cox proportional hazards models yielded crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of CV death and all-cause mortality associated with normalized BP (systolic BP <140 mmHg and diastolic BP <90 mmHg) compared with non-normalized BP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) in patients with HF. In sensitivity analyses we restricted to high-risk HF patients (≥80 years or with previous CV events). We also repeated the analyses in patients without HF to assess a potential effect modification. Results Among 1623 BIS participants treated with antihypertensive drugs at baseline, 544 (33.5%) had a diagnosis of HF. Of those, 255 (46.9%) showed normalized BP and 289 (53.1%) had non-normalized values. Mean age (standard deviation [SD]) was 82.8 (6.8) years (45.4% female). Selected patient characteristics are shown in the Table. Median (interquartile range) duration of follow-up was 6.7 (4.1-7.3) years. Compared with non-normalized BP, normalized BP was associated with a numerically increased risk of CV death (HR, 1.40; 95% CI, 0.90-2.17) and all-cause mortality (HR, 1.28; 95% CI, 0.96-1.71) in patients with HF. The associations were more pronounced or reached statistical significance when restricting to HF patients ≥80 years (CV death: HR, 1.54; 95% CI, 0.94-2.53 / all-cause mortality: HR, 1.56; 95% CI, 1.11-2.18) or HF patients with previous CV events (CV death: HR, 1.65; 95% CI, 0.83-3.29 / all-cause mortality: HR, 1.33; 95% CI, 0.85-2.07) (Figure). The effect estimates in patients without HF were comparable to those with HF (CV death: HR, 1.18; 95% CI, 0.78-1.78; p for interaction, 0.695 / all-cause mortality: HR, 1.20; 95% CI, 0.93-1.54; p for interaction, 0.604). Conclusion Our study suggests that normalized BP does not decrease the risk of CV death or all-cause mortality in elderly patients with HF and it could even increase the risk especially in high-risk subgroups. Thus, individualized benefit-risk assessment is required for the pharmacotherapy of HF in this vulnerable population.

scholarly journals Inequalities in heart failure care in a tax‐financed universal healthcare system: a nationwide population‐based cohort study

2020 ◽  
Vol 7 (5) ◽  
pp. 3095-3108
Author(s):  
Inge Schjødt ◽  
Søren P. Johnsen ◽  
Anna Strömberg ◽  
Jan B. Valentin ◽  
Brian B. Løgstrup
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Healthcare System ◽  
Population Based ◽  
Heart Failure Care ◽  
Universal Healthcare ◽  
System A ◽  
Universal Healthcare System

scholarly journals Outcomes in patients with heart failure treated in hospitals with varying admission rates: population-based cohort study

2014 ◽  
Vol 23 (12) ◽  
pp. 981-988 ◽  
Author(s):  
R Sacha Bhatia ◽  
Peter C Austin ◽  
Therese A Stukel ◽  
Michael J Schull ◽  
Alice Chong ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Population Based ◽  
Admission Rates ◽  
Patients With Heart Failure
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