Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Farr Institute of Health Informatics Research, Institute of Health Informatics, University College London, London, UK.
Eur J Heart Fail. 2019 Oct;21(10):1197-1206. doi: 10.1002/ejhf.1350. Epub 2019 Jan 7.
Several risk factors for incident heart failure (HF) have been previously identified, however large electronic health records (EHR) datasets may provide the opportunity to examine the consistency of risk factors across different subgroups from the general population.
We used linked EHR data from 2000 to 2010 as part of the UK-based CALIBER resource to select a cohort of 871 687 individuals 55 years or older and free of HF at baseline. The primary endpoint was the first record of HF from primary or secondary care. Cox proportional hazards analysis was used to estimate hazard ratios for associations between risk factors and incident HF, separately for men and women and by age category: 55-64, 65-74, and > 75 years. During 5.8 years of median follow-up, a total of 47 987 incident HF cases were recorded. Age, social deprivation, smoking, sedentary lifestyle, diabetes, atrial fibrillation, chronic obstructive pulmonary disease, body mass index, haemoglobin, total white blood cell count and creatinine were associated with HF. Smoking, atrial fibrillation and diabetes showed stronger associations with incident HF in women compared to men.
We confirmed associations of several risk factors with HF in this large population-based cohort across age and sex subgroups. Mainly modifiable risk factors and comorbidities are strongly associated with incident HF, highlighting the importance of preventive strategies targeting such risk factors for HF.
先前已经确定了一些发生心力衰竭（HF）的风险因素，但是大型电子健康记录（EHR）数据集可能有机会从一般人群的不同亚组中检查风险因素的一致性。
我们使用 2000 年至 2010 年期间作为英国基于 CALIBER 资源的一部分的链接 EHR 数据，选择了 871687 名 55 岁或以上且基线时无 HF 的个体的队列。主要终点是初级或二级保健中首次记录 HF。使用 Cox 比例风险分析分别针对男性和女性以及年龄组（55-64、65-74 和>75 岁）评估风险因素与 HF 事件之间的风险比。在中位数 5.8 年的随访期间，共记录了 47987 例 HF 事件。年龄、社会剥夺、吸烟、久坐不动的生活方式、糖尿病、房颤、慢性阻塞性肺疾病、体重指数、血红蛋白、总白细胞计数和肌酐与 HF 相关。与男性相比，吸烟、房颤和糖尿病与女性 HF 事件的相关性更强。
我们在这个基于人群的大型队列中，在年龄和性别亚组中证实了几个风险因素与 HF 的关联。主要是可改变的风险因素和合并症与 HF 事件密切相关，这突出了针对这些 HF 风险因素的预防策略的重要性。
