Incidence of first heart failure hospitalisation and mortality in Aboriginal and non-Aboriginal patients in Western Australia, 2000-2009

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Abstract

Objectives: To compare the incidence of first heart failure (HF) hospitalisation, antecedent risk factors and 1-year mortality between Aboriginal and non-Aboriginal populations in Western Australia (2000-2009).

Methods: A population-based cohort aged 20-84 years comprising Aboriginal (n = 1013; mean 54 ± 14 years) and non-Aboriginal patients (n = 16,366; mean 71 ± 11 years) with first HF hospitalisation was evaluated. Age and sex-specific incidence rates and HF antecedents were compared between subpopulations. Regression models were used to examine 30-day and 1-year (in 30-day survivors) mortality.

Results: Aboriginal patients were younger, more likely to reside in rural/remote areas (76% vs 23%) and to be women (50.6% vs 41.7%, all p <0.001). Aboriginal (versus non-Aboriginal) HF incidence rates were 11-fold higher in men and 23-fold in women aged 20-39 years, declining to about 2-fold in patients aged 70-84 years. Ischaemic and rheumatic heart diseases were more common antecedents of HF in younger (<55 years) Aboriginal versus non-Aboriginal patients (p <0.001). Hypertension, diabetes, chronic kidney disease, renal failure, chronic obstructive pulmonary disease, and a high Charlson comorbidity index (>= 3) were also more prevalent in younger and older Aboriginal patients (p <0.001). Although 30-day mortality was similar in both subpopulations, Aboriginal patients aged <55 years had a 1.9 risk-adjusted hazard ratio (HR) for 1-year mortality (p = 0.015).

Conclusions: Aboriginal people had substantially higher age and sex-specific HF incidence rate and prevalence of HF antecedents than their non-Aboriginal counterparts. HR for 1-year mortality was also significantly worse at younger ages, highlighting the urgent need for enhanced primary and secondary prevention of HF in this population. © 2014 Elsevier Ireland Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)110-117
JournalInternational Journal of Cardiology
Volume173
Issue number1
Early online date22 Feb 2014
DOIs
Publication statusPublished - Apr 2014

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Western Australia
Hospitalization
Heart Failure
Mortality
Incidence
Population
Primary Prevention
Secondary Prevention
Ireland
Survivors

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@article{a9145f9474fe4986a8874a1b5983ca1f,
title = "Incidence of first heart failure hospitalisation and mortality in Aboriginal and non-Aboriginal patients in Western Australia, 2000-2009",
abstract = "Objectives: To compare the incidence of first heart failure (HF) hospitalisation, antecedent risk factors and 1-year mortality between Aboriginal and non-Aboriginal populations in Western Australia (2000-2009). Methods: A population-based cohort aged 20-84 years comprising Aboriginal (n = 1013; mean 54 ± 14 years) and non-Aboriginal patients (n = 16,366; mean 71 ± 11 years) with first HF hospitalisation was evaluated. Age and sex-specific incidence rates and HF antecedents were compared between subpopulations. Regression models were used to examine 30-day and 1-year (in 30-day survivors) mortality. Results: Aboriginal patients were younger, more likely to reside in rural/remote areas (76{\%} vs 23{\%}) and to be women (50.6{\%} vs 41.7{\%}, all p <0.001). Aboriginal (versus non-Aboriginal) HF incidence rates were 11-fold higher in men and 23-fold in women aged 20-39 years, declining to about 2-fold in patients aged 70-84 years. Ischaemic and rheumatic heart diseases were more common antecedents of HF in younger (<55 years) Aboriginal versus non-Aboriginal patients (p <0.001). Hypertension, diabetes, chronic kidney disease, renal failure, chronic obstructive pulmonary disease, and a high Charlson comorbidity index (>= 3) were also more prevalent in younger and older Aboriginal patients (p <0.001). Although 30-day mortality was similar in both subpopulations, Aboriginal patients aged <55 years had a 1.9 risk-adjusted hazard ratio (HR) for 1-year mortality (p = 0.015). Conclusions: Aboriginal people had substantially higher age and sex-specific HF incidence rate and prevalence of HF antecedents than their non-Aboriginal counterparts. HR for 1-year mortality was also significantly worse at younger ages, highlighting the urgent need for enhanced primary and secondary prevention of HF in this population. {\circledC} 2014 Elsevier Ireland Ltd. All rights reserved.",
author = "Katherine Teng and Judith Katzenellenbogen and Sandra Thompson and Frank Sanfilippo and Matthew Knuiman and Elizabeth Geelhoed and Michael Hobbs and D.C. Bessarab and Joe Hung",
year = "2014",
month = "4",
doi = "10.1016/j.ijcard.2014.02.020",
language = "English",
volume = "173",
pages = "110--117",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - Incidence of first heart failure hospitalisation and mortality in Aboriginal and non-Aboriginal patients in Western Australia, 2000-2009

AU - Teng, Katherine

AU - Katzenellenbogen, Judith

AU - Thompson, Sandra

AU - Sanfilippo, Frank

AU - Knuiman, Matthew

AU - Geelhoed, Elizabeth

AU - Hobbs, Michael

AU - Bessarab, D.C.

AU - Hung, Joe

PY - 2014/4

Y1 - 2014/4

N2 - Objectives: To compare the incidence of first heart failure (HF) hospitalisation, antecedent risk factors and 1-year mortality between Aboriginal and non-Aboriginal populations in Western Australia (2000-2009). Methods: A population-based cohort aged 20-84 years comprising Aboriginal (n = 1013; mean 54 ± 14 years) and non-Aboriginal patients (n = 16,366; mean 71 ± 11 years) with first HF hospitalisation was evaluated. Age and sex-specific incidence rates and HF antecedents were compared between subpopulations. Regression models were used to examine 30-day and 1-year (in 30-day survivors) mortality. Results: Aboriginal patients were younger, more likely to reside in rural/remote areas (76% vs 23%) and to be women (50.6% vs 41.7%, all p <0.001). Aboriginal (versus non-Aboriginal) HF incidence rates were 11-fold higher in men and 23-fold in women aged 20-39 years, declining to about 2-fold in patients aged 70-84 years. Ischaemic and rheumatic heart diseases were more common antecedents of HF in younger (<55 years) Aboriginal versus non-Aboriginal patients (p <0.001). Hypertension, diabetes, chronic kidney disease, renal failure, chronic obstructive pulmonary disease, and a high Charlson comorbidity index (>= 3) were also more prevalent in younger and older Aboriginal patients (p <0.001). Although 30-day mortality was similar in both subpopulations, Aboriginal patients aged <55 years had a 1.9 risk-adjusted hazard ratio (HR) for 1-year mortality (p = 0.015). Conclusions: Aboriginal people had substantially higher age and sex-specific HF incidence rate and prevalence of HF antecedents than their non-Aboriginal counterparts. HR for 1-year mortality was also significantly worse at younger ages, highlighting the urgent need for enhanced primary and secondary prevention of HF in this population. © 2014 Elsevier Ireland Ltd. All rights reserved.

AB - Objectives: To compare the incidence of first heart failure (HF) hospitalisation, antecedent risk factors and 1-year mortality between Aboriginal and non-Aboriginal populations in Western Australia (2000-2009). Methods: A population-based cohort aged 20-84 years comprising Aboriginal (n = 1013; mean 54 ± 14 years) and non-Aboriginal patients (n = 16,366; mean 71 ± 11 years) with first HF hospitalisation was evaluated. Age and sex-specific incidence rates and HF antecedents were compared between subpopulations. Regression models were used to examine 30-day and 1-year (in 30-day survivors) mortality. Results: Aboriginal patients were younger, more likely to reside in rural/remote areas (76% vs 23%) and to be women (50.6% vs 41.7%, all p <0.001). Aboriginal (versus non-Aboriginal) HF incidence rates were 11-fold higher in men and 23-fold in women aged 20-39 years, declining to about 2-fold in patients aged 70-84 years. Ischaemic and rheumatic heart diseases were more common antecedents of HF in younger (<55 years) Aboriginal versus non-Aboriginal patients (p <0.001). Hypertension, diabetes, chronic kidney disease, renal failure, chronic obstructive pulmonary disease, and a high Charlson comorbidity index (>= 3) were also more prevalent in younger and older Aboriginal patients (p <0.001). Although 30-day mortality was similar in both subpopulations, Aboriginal patients aged <55 years had a 1.9 risk-adjusted hazard ratio (HR) for 1-year mortality (p = 0.015). Conclusions: Aboriginal people had substantially higher age and sex-specific HF incidence rate and prevalence of HF antecedents than their non-Aboriginal counterparts. HR for 1-year mortality was also significantly worse at younger ages, highlighting the urgent need for enhanced primary and secondary prevention of HF in this population. © 2014 Elsevier Ireland Ltd. All rights reserved.

U2 - 10.1016/j.ijcard.2014.02.020

DO - 10.1016/j.ijcard.2014.02.020

M3 - Article

VL - 173

SP - 110

EP - 117

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 1

ER -