Table 3. Changes in the Association of Race/Ethnicity With Incident Congestive Heart Failure After Adjusting for Established Risk Factors and Socioeconomic Status in 6814 Participants in the Multi-Ethnic Study of Atherosclerosis.
| Model | Racial/Ethnic Group, Hazard Ratio (95% Confidence Interval)a | |||
|---|---|---|---|---|
| White | Chinese American | African American | Hispanic | |
| Unadjusted (Model 1) | 1 [Reference] | 0.37 (0.11-1.24) | 1.81 (1.07-3.07) | 1.36 (0.75-2.47) |
| Established Risk Factors | ||||
| Model 1 + age | 1 [Reference] | 0.39 (0.12-1.29) | 1.90 (1.12-3.23) | 1.50 (0.83-2.73) |
| Model 1 + sex | 1 [Reference] | 0.37 (0.11-1.24) | 1.87 (1.10-3.17) | 1.37 (0.75-2.48) |
| Model 1 + hypertension | 1 [Reference] | 0.32 (0.10-1.09) | 1.50 (0.87-2.57) | 1.12 (0.61-2.06) |
| Model 1 + diabetes mellitus | 1 [Reference] | 0.38 (0.12-1.28) | 1.55 (0.91-2.63) | 1.36 (0.75-2.47) |
| Model 1 + obesity (BMI ≥30) | 1 [Reference] | 0.41 (0.12-1.36) | 1.71 (1.00-2.91) | 1.31 (0.72-2.39) |
| Model 1 + cigarette smoking | 1 [Reference] | 0.41 (0.12-1.37) | 1.72 (1.01-2.94) | 1.38 (0.76-2.51) |
| Model 1 + total cholesterol level | 1 [Reference] | 0.37 (0.11-1.24) | 1.82 (1.07-3.09) | 1.36 (0.74-2.46) |
| Model 1 + LV hypertrophy | 1 [Reference] | 0.33 (0.10-1.11) | 1.70 (1.00-2.92) | 1.33 (0.73-2.43) |
| Socioeconomic Factors | ||||
| Model 1 + household income | 1 [Reference] | 0.29 (0.09-0.97) | 1.66 (0.96-2.85) | 1.00 (0.53-1.89) |
| Model 1 + educational level | 1 [Reference] | 0.36 (0.11-1.21) | 1.82 (1.06-3.10) | 1.22 (0.63-2.37) |
| Access to Health Care and Medication | ||||
| Model 1 + health insurance | 1 [Reference] | 0.37 (0.11-1.24) | 1.81 (1.07-3.07) | 1.35 (0.73-2.48) |
| Model 1 + Medicare and Medicaid enrollmentb | 1 [Reference] | 0.36 (0.11-1.19) | 1.79 (1.05-3.05) | 1.32 (0.71-2.46) |
| Model 1 + ACEI use | 1 [Reference] | 0.40 (0.12-1.32) | 1.69 (1.00-2.89) | 1.33 (0.73-2.41) |
| Model 1 + β blocker use | 1 [Reference] | 0.37 (0.11-1.23) | 1.81 (1.07-3.07) | 1.37 (0.75-2.49) |
| Model 1 + CCB use | 1 [Reference] | 0.37 (1.10-1.22) | 1.66 (0.97-2.84) | 1.33 (0.73-2.42) |
| Lifestyle Factors | ||||
| Model 1 + total daily caloric intake | 1 [Reference] | 0.41 (0.12-1.37) | 1.71 (0.98-2.99) | 1.26 (0.68-2.36) |
| Model 1 + total trans-fatty acid intake per day | 1 [Reference] | 0.42 (0.12-1.42) | 1.69 (0.97-2.96) | 1.35 (0.72-2.51) |
| Model 1 + physical activity levelc | 1 [Reference] | 0.35 (0.11-1.17) | 1.89 (1.12-3.21) | 1.37 (0.75-2.49) |
| Proximal Risk Factors | ||||
| Model 1 + LVEF | 1 [Reference] | 0.73 (0.21-2.52) | 1.63 (0.86-3.12) | 1.31 (0.63-2.72) |
| Model 1 + LV mass indexd | 1 [Reference] | 0.53 (0.16-1.79) | 1.09 (0.55-2.15) | 1.00 (0.48-2.07) |
| Model 1 + coronary artery calcificatione | 1 [Reference] | 0.40 (0.12-1.32) | 2.07 (1.22-3.52) | 1.54 (0.84-2.79) |
| Model 1 + interim MI | 1 [Reference] | 0.41 (0.12-1.36) | 2.34 (1.38-3.97) | 1.44 (0.79-2.61) |
Abbreviations: ACEI, angiotensin-converting enzyme inhibitor; BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); CCB, calcium channel blocker; LV, left ventricle; LVEF, left ventricular ejection fraction; MI, myocardial infarction.
a
Variables were added to Model 1 one at a time. Boldface type indicates statistical significance at P = .05.
b
The interaction between Medicare and Medicaid was also included in this model.
c
Physical activity was determined as the sum of metabolic equivalents of all physical activities.
d
Left ventricle mass divided by body surface area.
e
Presence of coronary artery calcification was defined as a phantom-adjusted Agatston calcium score of more than 0.