Table 2.
Cumulative incidence of HF at age 50 across two epochs according to risk factor strata
| Adjusted cumulative incidence, % (95% CI), 1965-1989, Epoch 1 | Adjusted cumulative incidence, % (95% CI), 1990-2014, Epoch 2 | RLR Rate ratio Epoc h2/Epoch 1, P | ||||||
|---|---|---|---|---|---|---|---|---|
| 30-year | 40-year | Lifetime (RLR) | 30-year | 40-year | Lifetime (RLR) | |||
| Overall | N/Pyr | 458/102596 | 608/110715 | 624/111351 | 367/109961 | 758/126183 | 875/128903 | |
| ACI | 11.03 (10.07-11.99) | 17.54 (16.19-18.88) | 19.03 (17.52-20.53) | 9.26 (8.36-10.17) | 20.14 (18.86-21.43) | 23.68 (22.30-25.05) | 1.24 P<0.001 | |
| Sex | ||||||||
| Women | N/Pyr | 206/57921 | 304/63512 | 317/64013 | 152/60391 | 379/70916 | 455/72931 | |
| ACI | 9.03 (7.85-10.22) | 16.73 (14.90-18.57) | 18.86 (16.75-20.98) | 7.31 (6.18-8.43) | 18.63 (16.93-20.33) | 22.55 (20.73-24.38) | 1.20, P=0.010 | |
| Men | N/Pyr | 252/44676 | 304/47205 | 307/47338 | 215/49571 | 379/55268 | 420/55972 | |
| ACI | 13.49 (11.92-15.06) | 18.53 (16.54-20.52) | 19.19 (17.09-21.29) | 11.44 (9.99-12.88) | 22.01 (20.03-23.98) | 25.25 (23.14-27.36) | 1.32 P<0.001 | |
| P | <0.001 | 0.19 | 0.83 | <0.001 | 0.011 | 0.06 | ||
| BMI category | ||||||||
| Normal | N/Pyr | 131/40971 | 166/43382 | 169/43490 | 82/38016 | 228/45585 | 277/46975 | |
| ACI | 8.40 (7.00-9.81) | 14.07 (11.77-16.37) | 17.65 (13.34-21.95) | 5.83 (4.60-7.05) | 15.70 (13.83-17.57) | 19.24 (17.20-21.28) | 1.09 P=0.51 | |
| Overweight | N/Pyr | 164/37148 | 209/39601 | 212/39690 | 133/37156 | 287/42680 | 335/43583 | |
| ACI | 11.04 (9.42-12.66) | 17.02 (14.71-19.32) | 18.10 (15.53-20.66) | 9.98 (8.37-11.60) | 22.23 (19.96-24.50) | 26.24 (23.82-28.65) | 1.45 P<0.001 | |
| Obese | N/Pyr | 81/12716 | 96/13313 | 97/13338 | 103/19309 | 162/20835 | 176/21054 | |
| ACI | 15.64 (12.42-18.87) | 22.09 (17.77-26.41) | 23.09 (18.49-28.10) | 16.71 (13.71-19.72) | 29.95 (25.98-33.93) | 33.07 (28.97-37.16) | 1.43 P=0.002 | |
| P Overweight vs. normal | 0.016 | 0.08 | 0.86 | <0.001 | <0.001 | <0.001 | ||
| P Obese vs. normal | <0.001 | 0.001 | 0.09 | <0.001 | <0.001 | <0.001 | ||
| BP category | ||||||||
| Normal | N/Pyr | 70/29389 | 87/30875 | 90/30942 | 64/44377 | 160/50279 | 209/51253 | |
| ACI | 6.88 (5.27-8.48) | 12.09 (9.02-15.16) | 15.25 (10.73-19.77) | 4.65 (3.52-5.79) | 13.52 (11.54-15.49) | 18.67 (16.36-20.99) | 1.22 P=0.19 | |
| Intermediate | N/Pyr | 116/32652 | 147/34485 | 148/34553 | 114/26545 | 249/31979 | 281/32927 | |
| ACI | 9.79 (8.05-11.54) | 15.94 (13.25-18.64) | 16.42 (13.59-19.25) | 10.47 (8.65-12.30) | 21.46 (19.09-23.83) | 24.21 (21.74-26.68) | 1.47 P<0.001 | |
| Hypertension | N/Pyr | 194/29805 | 243/31999 | 246/32085 | 140/24367 | 268/27805 | 298/28417 | |
| ACI | 14.36 (12.47-16.25) | 20.35 (17.94-22.75) | 23.75 (19.77-27.73) | 14.38 (12.17-16.58) | 27.52 (24.71-30.33) | 30.40 (27.52-33.29) | 1.28 P=0.008 | |
| P Intermediate vs. Normal | 0.016 | 0.064 | 0.67 | <0.001 | <0.001 | <0.001 | ||
| P Hypertension vs. Normal | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | ||
| Diabetes Status | ||||||||
| Normal | N/Pyr | 350/88180 | 435/93206 | 439/93357 | 292/91510 | 642/105777 | 752/108237 | |
| ACI | 10.25 (9.21-11.29) | 16.06 (14.48-17.64) | 17.03 (15.21-18.86) | 9.00 (8.01-9.99) | 20.26 (18.85-21.66) | 23.98 (22.49-25.48) | 1.41 P<0.001 | |
| Diabetes | N/Pyr | 13/798 | - | - | 22/2386 | 24/2434 | 24/2438 | |
| ACI | 33.67 (18.40-48.93) | - | - | 30.13 (18.60-41.66) | 39.24 (24.47-54.02) | 39.24 (24.47-54.02) | - | |
| P Diabetes vs. Normal | 0.003 | - | - | <0.001 | 0.012 | 0.044 | ||
| Cumulative Risk factor burden * | ||||||||
| Low* | N/PYrs | 92/39395 | 120/41396 | 122/41447 | 86/46913 | 220/54590 | 279/55928 | |
| ACI | 6.86 (5.47-8.26) | 12.35 (9.85-14.85) | 14.22 (10.66-17.78) | 5.50 (4.37-6.64) | 14.83 (13.02-16.65) | 19.35 (17.30-22.40) | 1.36 P=0.014 | |
| Intermediate* | N/PYrs | 204/41298 | 248/43924 | 250/44008 | 150/36251 | 336/42097 | 381/43101 | |
| ACI | 12.00 (10.43-13.57) | 17.11 (15.01-19.21) | 17.85 (15.54-20.16) | 10.79 (9.16-12.42) | 23.85 (21.63-26.08) | 27.07 (24.75-29.40) | 1.52 P<0.001 | |
| High* | N/PYrs | 63/7341 | 75/7706 | - | 78/9974 | 110/10628 | 116/10731 | |
| ACI | 18.61 (14.40-22.81) | 25.33 (20.03-30.63) | - | 22.51 (18.01-27.02) | 35.57 (30.08-41.06) | 37.28 (31.79-42.78) | - | |
| P Intermediate vs. Low | <0.001 | 0.004 | 0.09 | <0.001 | <0.001 | <0.001 | ||
| P high vs. Low | <0.001 | <0.001 | - | <0.001 | <0.001 | <0.001 | ||
ACI= adjusted cumulative incidence %. N = number of HF events, Pyrs= person-years of observation.
Lifetime risk evaluated at up to 45 years of follow-up except for the analyses of the stratum according to diabetes status, in which 30 years of follow-up was used due to limited data.
participants received a score of 0-2 for the three BMI categories (0 for normal BMI, 1 for overweight, and 2 for obesity), a score of 0-2 for BP categories (0 for normal BP, 1 for intermediate BP, and 2 for hypertension), a score of 0-1 for diabetes (0= no, 1= yes), and a score of 0-1 for myocardial infarction before age 50 (0=no, 1=yes). Thus, participants could have a score that ranged from 0 (minimum) to 6 (maximum). Three strata of the risk score were empirically defined as 0-1 (low risk factor burden), 2-3 (intermediate), 4-6 (high risk factor burden).