Abstract 9759: Race and Gender Differences in Survival Among Hospitalized Heart Failure With Preserved Ejection Fraction: The Atherosclerosis Risk in Communities (ARIC) Surveillance Study

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) accounts for about half of HF hospitalizations, and has been reported to be more common amongst Caucasians and women in outpatient population studies. There are limited data, however, on the influence of race and gender on survival in HFpEF. We evaluated whether clinical characteristics and outcomes differ amongst HFpEF patients by race and gender. Methods: HFpEF (EF≥ 50%) hospitalization cases from 2005-2009 adjudicated by a physician panel were analyzed from the community-based surveillance component of the ARIC study, comprising 4 US communities (Jackson, MS; Washington County, MD; Minneapolis, MN; and Forsyth County, NC; combined population in 2009 = 214,000). The association of race and gender with mortality at 28-days and 1-year was evaluated. Results: Of 3,786 (weighted n = 18,265) adjudicated acute decompensated HF cases, 1,726 (weighted n = 8114) were categorized as HFpEF. Patient characteristics included: female (44%), African American (AA, 32%), hypertension (83%), diabetes (46%), and mean BMI of 28. Compared to Caucasians, AA’s were younger (70 vs. 77 years, p<0.001), more frequently women (47% vs. 42%, p<0.001), with higher systolic blood pressure (SBP, 145 vs. 135 mmHg, p<0.001), and more prior HF hospitalizations (50% vs. 37%, p<0.001). Compared to men, women were older (76 vs. 73 years, p<0.001), with higher SBP (141 vs. 138 mmHg, p=0.03), and better renal function (eGFR 42 vs. 38 mL/min/1.73m 2 , p<0.001). Overall 28-day and 1-year mortality was 13.1% and 32.8%, respectively, with no differences in un-adjusted or adjusted estimates by race or gender (Table 1). Conclusions: In hospitalized HFpEF patients, overall 28-day and 1-year mortality were high without apparent race- or gender-based differences in mortality. These data may help inform the development of future interventions and resource allocation.