TABLE 1.
Baseline Patient and Hospital Characteristics for HFpEF Patients Overall and According to Racial/Ethnic Groups
| Overall (N = 53,065) | White (n = 44,871) | Black (n = 4,767) | Hispanic (n = 2,260) | Asian (n = 842) | Other (n = 325) | p Value | Standardized Difference White vs.
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|---|---|---|---|---|---|---|---|---|---|---|---|
| Black | Hispanic | Asian | Other | ||||||||
| Demographic characteristics | |||||||||||
| Age, yrs | 82 (75–88) | 83 (76–88) | 77 (71–84) | 79 (72–85) | 81 (75–87) | 77 (71–83) | <0.0001 | 0.521 | 0.346 | 0.134 | 0.517 |
| Age (categorical), yrs | <0.0001 | ||||||||||
| 65–69 | 10.65 | 9.26 | 20.54 | 16.02 | 11.64 | 17.54 | 0.321 | 0.204 | 0.078 | 0.245 | |
| 70–74 | 12.76 | 11.79 | 19.93 | 16.46 | 11.28 | 19.69 | 0.224 | 0.134 | 0.016 | 0.218 | |
| 75–79 | 16.10 | 15.56 | 19.13 | 18.58 | 19.95 | 18.77 | 0.094 | 0.080 | 0.115 | 0.085 | |
| ≥80 | 60.49 | 63.39 | 40.40 | 48.94 | 57.13 | 44.00 | 0.473 | 0.294 | 0.128 | 0.396 | |
| Female | 66.24 | 65.75 | 70.40 | 68.32 | 62.47 | 68.31 | <0.0001 | 0.100 | 0.055 | 0.068 | 0.055 |
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| Medical history | |||||||||||
| Atrial flutter/fibrillation | 44.12 | 47.33 | 25.33 | 25.44 | 31.85 | 32.55 | <0.0001 | 0.470 | 0.467 | 0.320 | 0.305 |
| COPD or asthma | 31.54 | 31.76 | 32.73 | 28.51 | 22.34 | 28.86 | <0.0001 | 0.021 | 0.071 | 0.213 | 0.063 |
| Diabetes | 39.17 | 36.36 | 56.38 | 56.03 | 43.91 | 50.00 | <0.0001 | 0.410 | 0.402 | 0.154 | 0.278 |
| Hyperlipidemia | 49.05 | 49.26 | 47.22 | 48.84 | 49.11 | 47.32 | 0.1314 | 0.041 | 0.008 | 0.003 | 0.039 |
| Hypertension | 81.29 | 80.22 | 89.76 | 84.73 | 82.74 | 78.86 | <0.0001 | 0.270 | 0.119 | 0.065 | 0.034 |
| Peripheral vascular disease | 12.49 | 12.75 | 11.70 | 11.87 | 5.46 | 11.07 | <0.0001 | 0.032 | 0.027 | 0.256 | 0.052 |
| CAD | 44.51 | 45.33 | 37.26 | 44.44 | 41.24 | 45.30 | <0.0001 | 0.165 | 0.018 | 0.083 | 0.001 |
| Prior MI | 13.07 | 13.41 | 11.29 | 11.30 | 9.77 | 12.42 | <0.0001 | 0.064 | 0.064 | 0.114 | 0.030 |
| CVA/TIA | 16.88 | 16.70 | 19.82 | 15.18 | 16.12 | 12.42 | <0.0001 | 0.081 | 0.042 | 0.016 | 0.122 |
| ICD only | 1.43 | 1.48 | 1.26 | 1.09 | 1.02 | 1.01 | 0.3242 | 0.019 | 0.035 | 0.042 | 0.042 |
| Anemia | 22.22 | 21.93 | 26.25 | 20.57 | 18.78 | 24.16 | <0.0001 | 0.101 | 0.033 | 0.078 | 0.053 |
| Dialysis (chronic) | 3.19 | 2.21 | 8.82 | 8.09 | 9.26 | 8.05 | <0.0001 | 0.293 | 0.268 | 0.307 | 0.267 |
| Renal insufficiency, chronic (SCr >2.0) | 20.48 | 19.14 | 30.42 | 24.21 | 24.75 | 25.17 | <0.0001 | 0.263 | 0.123 | 0.136 | 0.146 |
| Depression | 11.97 | 12.73 | 7.02 | 10.26 | 5.20 | 7.38 | <0.0001 | 0.192 | 0.077 | 0.266 | 0.178 |
| Ischemic etiology: medical history of CAD, MI, prior PCI, prior CABG, or prior PCI/CABG | 49.34 | 50.23 | 41.26 | 49.93 | 45.18 | 49.66 | <0.0001 | 0.181 | 0.006 | 0.101 | 0.011 |
| Medical history panel missing | 5.69 | 5.50 | 6.75 | 6.42 | 6.41 | 8.31 | 0.0005 | 0.052 | 0.039 | 0.038 | 0.111 |
| Smoking | 6.92 | 6.64 | 10.05 | 6.75 | 4.32 | 7.17 | <0.0001 | 0.124 | 0.004 | 0.102 | 0.021 |
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| Vitals on admission | |||||||||||
| Heart rate, beats/min | 79 (68–92) | 79 (68–92) | 79 (68–91) | 78 (68–91) | 77 (68–93) | 80 (69–92) | 0.459 | 0.007 | 0.025 | 0.007 | 0.033 |
| SBP, mm Hg | 144 (125–165) | 143 (124–163) | 153 (133–178) | 149 (130–172) | 147 (128–166) | 144 (123–162) | <0.0001 | 0.345 | 0.218 | 0.118 | 0.000 |
| DBP, mm Hg | 72 (62–84) | 72 (62–83) | 76 (66–88) | 72 (62–84) | 72 (62–84) | 73 (63–84) | <0.0001 | 0.271 | 0.057 | 0.021 | 0.078 |
| BMI, kg/m2 | 27.66 (23.43–33.27) | 27.46 (23.27–32.95) | 30.07 (25.21–36.33) | 29 (24.61–34.06) | 23.84 (21.03–27.55) | 29.26 (24.47–34.55) | <0.0001 | 0.320 | 0.157 | 0.567 | 0.108 |
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| Laboratory measures | |||||||||||
| LVEF source | 0.0155 | ||||||||||
| Quantitative LVEF | 91.31 | 91.17 | 92.22 | 91.55 | 93.59 | 90.15 | 0.038 | 0.013 | 0.091 | 0.035 | |
| Qualitative LVEF | 8.69 | 8.83 | 7.78 | 8.45 | 6.41 | 9.85 | 0.038 | 0.013 | 0.091 | 0.035 | |
| EF, % | 60 (55–64) | 60 (55–64) | 60 (55–65) | 60 (55–65) | 60 (55–65) | 60 (55–65) | <0.0001 | 0.082 | 0.026 | 0.130 | 0.100 |
| Serum creatinine, mg/dl | 1.2 (0.9–1.7) | 1.2 (0.9–1.7) | 1.5 (1.1–2.4) | 1.3 (0.9–2) | 1.3 (0.9–2.1) | 1.3 (0.9–2.1) | <0.0001 | 0.127 | 0.090 | 0.109 | 0.102 |
| Serum sodium, mEq/L | 138 (135–141) | 138 (135–141) | 139 (137–142) | 138 (135–140) | 137 (134–140) | 138 (135–140) | <0.0001 | 0.107 | 0.141 | 0.130 | 0.054 |
| BUN, mg/dl | 25 (18–36) | 25 (18–36) | 25 (17–39) | 25 (18–40) | 26 (18–39.5) | 25 (17.5–40.5) | 0.0086 | 0.057 | 0.106 | 0.136 | 0.111 |
| BNP, admission, pg/ml | 562 (297–1,038.8) | 560 (304–1,020) | 571 (234.5–1,199.5) | 564 (270–1,120) | 627 (316–1,140) | 598 (275.5–1120.5) | 0.4905 | 0.130 | 0.085 | 0.079 | 0.029 |
| Hemoglobin, g/dl | 11.4 (10.1–12.8) | 11.5 (10.2–12.8) | 10.9 (9.6–12.2) | 11.3 (9.9–12.5) | 11.3 (10–12.7) | 10.9 (9.6–12.2) | <0.0001 | 0.168 | 0.069 | 0.007 | 0.274 |
| HbA1C (0–20), % | 6.5 (5.9–7.4) | 6.5 (5.9–7.3) | 6.6 (5.9–7.6) | 6.8 (6–7.7) | 6.6(6–7.3) | 6.5 (6–8.4) | 0.0102 | 0.078 | 0.188 | 0.017 | 0.166 |
| Total cholesterol (10–1,000), mg/dL | 135 (112–163) | 134 (111–161) | 142 (118–172) | 134 (114–166) | 139(116–166) | 121 (102–147) | <0.0001 | 0.214 | 0.099 | 0.152 | 0.279 |
| HDL (0–120), mg/dl | 41 (33–51) | 40 (32–51) | 46 (36–56) | 41 (32–52) | 42 (35–52) | 40 (32–47) | <0.0001 | 0.299 | 0.039 | 0.141 | 0.033 |
| LDL (30–500), mg/dl | 73 (56–94) | 72 (55–94) | 78 (58–101) | 72 (57–97) | 74 (59–92) | 64 (50–89) | <0.0001 | 0.188 | 0.074 | 0.045 | 0.200 |
| Triglycerides (5–2,000), mg/dl | 88 (65–122) | 89 (66–123) | 78 (59–110) | 95 (70–132) | 93 (64–127) | 94 (69.5–126) | <0.0001 | 0.223 | 0.123 | 0.027 | 0.036 |
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| Admission medications | |||||||||||
| ACE inhibitors | 29.43 | 29.41 | 30.61 | 29.81 | 21.50 | 33.16 | 0.0007 | 0.026 | 0.009 | 0.183 | 0.081 |
| ARB | 16.98 | 16.23 | 19.32 | 22.57 | 26.49 | 23.32 | <0.0001 | 0.081 | 0.161 | 0.252 | 0.179 |
| Aldosterone antagonist | 5.51 | 5.60 | 5.61 | 3.80 | 4.99 | 4.66 | 0.0551 | 0.000 | 0.086 | 0.027 | 0.043 |
| Aspirin | 44.40 | 45.14 | 40.84 | 40.10 | 32.82 | 53.37 | <.0001 | 0.087 | 0.102 | 0.255 | 0.165 |
| Beta-blocker | 54.93 | 55.05 | 54.41 | 55.21 | 50.10 | 54.92 | 0.2437 | 0.013 | 0.003 | 0.099 | 0.003 |
| Diabetic medications (any) | 23.56 | 21.56 | 34.00 | 36.92 | 31.36 | 35.38 | <0.0001 | 0.281 | 0.343 | 0.224 | 0.310 |
| Anticoagulation therapy | 27.57 | 29.61 | 16.98 | 14.98 | 15.36 | 15.54 | <0.0001 | 0.302 | 0.357 | 0.347 | 0.341 |
| Diuretic | 60.75 | 61.87 | 56.96 | 52.86 | 44.15 | 57.51 | <0.0001 | 0.100 | 0.183 | 0.361 | 0.089 |
| Hydralazine | 6.78 | 5.80 | 15.01 | 9.73 | 6.91 | 4.66 | <0.0001 | 0.305 | 0.147 | 0.046 | 0.051 |
| Lipid-lowering agent (any) | 55.05 | 54.71 | 56.89 | 57.00 | 55.09 | 62.69 | 0.0166 | 0.044 | 0.046 | 0.008 | 0.163 |
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| Year of index admission | <0.0001 | ||||||||||
| 2006 | 7.11 | 7.23 | 7.53 | 5.00 | 5.34 | 3.08 | 0.011 | 0.093 | 0.078 | 0.189 | |
| 2007 | 6.90 | 6.82 | 8.27 | 6.90 | 4.04 | 4.62 | 0.055 | 0.003 | 0.123 | 0.095 | |
| 2008 | 6.98 | 6.79 | 7.97 | 7.79 | 8.43 | 9.85 | 0.045 | 0.038 | 0.062 | 0.111 | |
| 2009 | 8.70 | 8.67 | 9.38 | 7.74 | 8.67 | 9.23 | 0.025 | 0.034 | 0.000 | 0.020 | |
| 2010 | 11.00 | 10.85 | 11.29 | 11.73 | 14.01 | 14.77 | 0.014 | 0.028 | 0.096 | 0.118 | |
| 2011 | 13.05 | 12.95 | 13.03 | 13.36 | 14.73 | 21.54 | 0.002 | 0.012 | 0.052 | 0.229 | |
| 2012 | 14.12 | 14.26 | 12.99 | 12.79 | 16.27 | 15.38 | 0.037 | 0.043 | 0.056 | 0.032 | |
| 2013 | 16.33 | 16.39 | 15.42 | 17.43 | 16.98 | 12.00 | 0.027 | 0.028 | 0.016 | 0.126 | |
| 2014 | 15.81 | 16.04 | 14.14 | 17.26 | 11.52 | 9.54 | 0.053 | 0.033 | 0.131 | 0.196 | |
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| Hospital characteristics | |||||||||||
| Hospital size (no. of beds) | 348 (227–527) | 348 (222–481) | 438 (292–610) | 296 (243–438) | 330 (217–400) | 358 (194–368) | <0.0001 | 0.444 | 0.008 | 0.047 | 0.186 |
| Geographic region | <0.0001 | ||||||||||
| West | 10.47 | 9.73 | 3.29 | 17.88 | 60.81 | 35.38 | 0.263 | 0.238 | 1.265 | 0.645 | |
| South | 31.70 | 30.40 | 43.36 | 41.19 | 15.20 | 16.92 | 0.271 | 0.227 | 0.368 | 0.321 | |
| Midwest | 23.14 | 24.13 | 22.99 | 8.41 | 8.79 | 28.62 | 0.027 | 0.436 | 0.423 | 0.102 | |
| Northeast | 34.70 | 35.74 | 30.35 | 32.52 | 15.20 | 19.08 | 0.115 | 0.068 | 0.485 | 0.380 | |
| Rural location | 6.98 | 7.42 | 4.95 | 1.15 | 7.15 | 16.36 | <0.0001 | 0.103 | 0.313 | 0.010 | 0.279 |
| Teaching status | 56.13 | 55.18 | 72.00 | 40.53 | 51.37 | 74.77 | <0.0001 | 0.355 | 0.296 | 0.076 | 0.420 |
| Heart transplants performed at site | 9.22 | 9.11 | 12.72 | 5.16 | 7.71 | 5.56 | <0.0001 | 0.116 | 0.154 | 0.050 | 0.137 |
Values are median (IQR) or %. Standardized differences are referenced to white patients.
ACE = angiotensin-converting enzyme; ARB = angiotensin II receptor blocker; BMI = body mass index; BNP = B-type natriuretic peptide; BUN = blood urea nitrogen; CABG = coronary artery bypass grafting; CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease; CVA = cerebrovascular accident; DBP = diastolic blood pressure; EF = ejection fraction; HbA1C = hemoglobin A1C; HDL = high-density lipoprotein; HFpEF = heart failure with preserved ejection fraction; ICD = implantable cardioverter-defibrillator; IQR = interquartile range; LDL = low-density lipoprotein; LVEF = left ventricular ejection fraction; MI = myocardial infarction; PCI = percutaneous coronary intervention; SBP = systolic blood pressure; SCr = serum creatinine; TIA = transient ischemic attack.