Rurality and race in heart failure risk: Insights from the Southern Community Cohort Study

S. Kotit
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Abstract

Introduction: Rural-urban health disparities are apparent in the burden of disease and health outcomes, including cardiovascular disease (CVD), specifically heart failure (HF). However, the factors influencing these disparities are not fully understood. Study and results: Among 27,115 participants in the Southern Community Cohort Study (SCCS) (mean age: 54 years (47-65)), 18,647 (68.8%) were black, 8,468 (32.3%) were white, and 20% resided in rural areas. Over a median 13-year follow-up period, 7,542 HF events occurred (rural=1,865 vs. urban=5,677). The age-adjusted HF incidence was 29.6 (95% CI,28.9-30.5) and 36.5 (95% CI, 34.9-38.3) per 1,000 person-years for urban and rural participants, respectively (P<.001). The risk of HF associated with rurality varied by race and sex. Rural black men had the highest risk across all groups (HR, 1.34; 95% CI, 1.19-1.51) (age-adjusted incidence rate: 40.4/1000 person-years (95% CI, 36.8-44.3)) followed by black women (HR, 1.18; 95% CI, 1.08-1.28) and white women (HR, 1.22; 95% CI, 1.07-1.39). Rurality was not associated with HF risk among white men (HR, 0.97; 95% CI, 0.81-1.16).
心力衰竭风险中的乡村和种族:南方社区队列研究的启示
城乡健康差异在疾病负担和健康结果方面很明显,包括心血管疾病(CVD),特别是心力衰竭(HF)。然而,影响这些差异的因素尚未完全了解。研究和结果:在南方社区队列研究(SCCS)的27,115名参与者(平均年龄:54岁(47-65岁))中,18,647名(68.8%)为黑人,8,468名(32.3%)为白人,20%居住在农村地区。在中位13年随访期间,发生了7542例心衰事件(农村= 1865例,城市= 5677例)。在城市和农村参与者中,年龄调整后的HF发病率分别为每1000人年29.6 (95% CI,28.9-30.5)和36.5 (95% CI, 34.9-38.3) (P< 0.001)。与农村生活相关的心衰风险因种族和性别而异。农村黑人男性在所有群体中风险最高(HR, 1.34;95% CI, 1.19-1.51)(年龄调整后的发病率:40.4/1000人-年(95% CI, 36.8-44.3)),其次是黑人女性(HR, 1.18;95% CI, 1.08-1.28)和白人女性(HR, 1.22;95% ci, 1.07-1.39)。农村性与白人男性HF风险无关(HR, 0.97;95% ci, 0.81-1.16)。
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