65
Table 27. Risk of HF and Outcomes in Special Populations
Vulnerable
Population Risk of HF HF Outcomes
Women e lifetime risk of HF is
equivalent between sexes,
but HFpEF risk is higher in
women—in FHS participants
with new-onset HF, odds of
HfpEF (EF >45%) are 2.8-fold
higher in women than in men.
Sex-specific differences in the
predictive value of cardiac
biomarkers for incident HF.
Nontraditional cardiovascular
risk factors, including anxiety,
depression, caregiver stress,
and low household income
may contribute more toward
incident heart disease in
women than men.
Overall, more favorable
survival with HF than men. In
the OPTIMIZE-HF registry,
women with acute HF had a
lower 1-y mortality (HR, 0.93;
95% CI, 0.89–0.97), although
women are more likely not to
receive optimal GDMT.
Lower patient-reported quality
of life for women with HFrEF,
compared with men.
Greater transplant waitlist
mortality for women but
equivalent survival aer heart
transplantation or LVAD
implantation.
Older adults Per FHS, at 40 y of age, the
lifetime risk of incident HF is
20% for both sexes; at 80 y of
age, the risk remains 20% for
men and women despite the
shorter life expectancy.
LVEF is preserved in at least
two-thirds of older adults with
the diagnosis of HF.
Among 1233 patients with
HF aged ≥80 y, 40% mortality
during mean 27-mo follow-
up; survival associated with
prescription of GDMT.
Lower
socioeconomic
status populations
Among 27,078 White and
Black adults of low income
(70% earned <$15,000/y)
participating from 2002–2009
in the Southern Community
Cohort Study, a 1 interquartile
increase in neighborhood
deprivation index was
associated with a 12% increase
in risk of HF (adjusted HR,
1.12; 95% CI, 1.07–1.18).
Age-adjusted 1999–2018 HF
mortality (deaths/100,000;
mean and 95% CI) was higher
with increasing quartiles of
ADI, which is based on 17
indicators of employment,
poverty, and education:
Quartile 1, 20.0 (19.4–20.5);
Quartile 2, 23.3 (22.6–24.0);
Quartile 3, 26.4 (25.5–27.3);
Quartile 4, 33.1 (31.8–34.4)
