CLINICAL STUDIES
Association of body mass, gender and race with heart failure primarily due to hypertension
Stephanie H. Dunlap, DO ,
Carla A. Sueta, MD, PhD, FACC*,
Lisa Tomasko, DrPH* and
Kirkwood F. Adams, Jr., MD, FACC*
* Departments of Medicine and Radiology, School of Medicine, and the Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
Section of Cardiology, University of Illinois at Chicago, Chicago, Illinois, USA
Manuscript received October 27, 1997;
revised manuscript received May 12, 1999,
accepted June 28, 1999.
Reprint requests and correspondence: Dr. Stephanie H. Dunlap, Section of Cardiology M/C 787, University of Illinois at Chicago, 840 S. Wood Street, Chicago, Illinois 60612
sdunlap{at}uic.edu
OBJECTIVES
This study was performed to determine the association between clinical characteristics, particularly body mass and race, and the likelihood of hypertension as the primary etiology for heart failure (HTNCM).
BACKGROUND
Although held to be important in the development of heart failure, the clinical characteristics predictive of HTNCM have not been well delineated.
METHODS
The study analysis was conducted using 680 patients from the University of North Carolina Heart Failure Database. This data set is racially diverse (44% African-American) and contains data concerning baseline clinical characteristics and cardiac function in patients with and without HTNCM. Logistic regression techniques determined independent predictors of HTNCM among the entire study population as well as the subgroup of study patients with hypertension.
RESULTS
Hypertension was present in 51% of the study patients but was the primary etiology of heart failure in only 25%. Body mass, race, gender and baseline systolic blood pressure were identified as significant independent predictors of the likelihood of HTNCM (all p < 0.001). These characteristics were predictors in the total study population and also in the subgroup of study patients with hypertension.
CONCLUSIONS
Hypertension remains a common etiologic factor for the development of heart failure but was the primary cause of heart failure in a minority of study patients. However, the presence of increased body mass, female gender, African-American ethnic origin or elevated baseline systolic blood pressure significantly increased the likelihood of HTNCM.
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Abbreviations and Acronyms
| | CAD | = coronary artery disease | | EKGLVH | = electrocardiographic evidence of left ventricular hypertrophy | | HTNCM | = hypertension as the primary etiology of heart failure | | HTNDX | = diagnosis of hypertension by study criteria | | NYHA | = New York Heart Association |
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