A population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults: The Strong Heart Study

Richard B. Devereux, Mary J. Roman, Mary Paranicas, Elisa T. Lee, Thomas K. Welty, Richard R. Fabsitz, David Robbins, Everett R. Rhoades, Richard J. Rodeheffer, Linda D. Cowan, Barbara V. Howard

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Background: Although clinical congestive heart failure (CHF) is increasingly common, few data document the prevalence and correlates of underlying left ventricular (LV) systolic dysfunction (D) in population-based samples. Methods: Echocardiography was used in the second Strong Heart Study (SHS) examination to identify mild and severe LVD (LV ejection fraction [EF] 40%-54% and <40%, respectively) in 3184 American Indians. Results: Mild and severe LVD were more common in men than women (17.4% vs 7.2% and 4.7% vs 1.8%) and in diabetic than nondiabetic participants (12.7% vs 9.1% and 3.5% vs 1.6%). Stepwise increases were observed from participants with normal EF to those with mild and severe LVD in age (mean 60 vs 61 and 63 years, P< .001), prevalence of overt CHF (2% vs 6% and 28%) and definite coronary heart disease (3% vs 11% and 32%), systolic pressure (129 vs 135 and 136 mm Hg), serum creatinine level (0.98 vs 1.34 and 2.16 mg/dL), and log urinary albumin/creatinine level (3.2 vs 3.7 and 4.7); a negative relation was seen with body mass index (31.1 vs 31.0 and 28.4 kg/m2) (all P< .001). In multivariate analyses lower LVEFs were independently associated with clinical CHF and coronary heart disease, lower myocardial contractility, male sex, hypertension, oveweight, arterial stiffening (higher pulse pressure/stroke volume) and renal dysfunction (higher serum creatinine level), higher LV mass, and lower relative wall thickness. Conclusion: LVD, present in approximately 14% of middle-aged to elderly adults, is independently associated with overt heart failure and coronary heart disease, male sex, hypertension, overweight, arterial stiffening, and renal target organ damage and, less consistently, with older age and diabetes.

Original languageEnglish (US)
Pages (from-to)439-446
Number of pages8
JournalAmerican Heart Journal
Volume141
Issue number3
DOIs
StatePublished - 2001

Fingerprint

Left Ventricular Dysfunction
Heart Failure
Coronary Disease
Creatinine
Stroke Volume
Population
Blood Pressure
Hypertension
Kidney
North American Indians
Serum
Echocardiography
Albumins
Body Mass Index
Multivariate Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Devereux, R. B., Roman, M. J., Paranicas, M., Lee, E. T., Welty, T. K., Fabsitz, R. R., ... Howard, B. V. (2001). A population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults: The Strong Heart Study. American Heart Journal, 141(3), 439-446. https://doi.org/10.1067/mhj.2001.113223

A population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults : The Strong Heart Study. / Devereux, Richard B.; Roman, Mary J.; Paranicas, Mary; Lee, Elisa T.; Welty, Thomas K.; Fabsitz, Richard R.; Robbins, David; Rhoades, Everett R.; Rodeheffer, Richard J.; Cowan, Linda D.; Howard, Barbara V.

In: American Heart Journal, Vol. 141, No. 3, 2001, p. 439-446.

Research output: Contribution to journalArticle

Devereux, RB, Roman, MJ, Paranicas, M, Lee, ET, Welty, TK, Fabsitz, RR, Robbins, D, Rhoades, ER, Rodeheffer, RJ, Cowan, LD & Howard, BV 2001, 'A population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults: The Strong Heart Study', American Heart Journal, vol. 141, no. 3, pp. 439-446. https://doi.org/10.1067/mhj.2001.113223
Devereux, Richard B. ; Roman, Mary J. ; Paranicas, Mary ; Lee, Elisa T. ; Welty, Thomas K. ; Fabsitz, Richard R. ; Robbins, David ; Rhoades, Everett R. ; Rodeheffer, Richard J. ; Cowan, Linda D. ; Howard, Barbara V. / A population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults : The Strong Heart Study. In: American Heart Journal. 2001 ; Vol. 141, No. 3. pp. 439-446.
@article{a0cf9284eb5f478a8c60711950b02c31,
title = "A population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults: The Strong Heart Study",
abstract = "Background: Although clinical congestive heart failure (CHF) is increasingly common, few data document the prevalence and correlates of underlying left ventricular (LV) systolic dysfunction (D) in population-based samples. Methods: Echocardiography was used in the second Strong Heart Study (SHS) examination to identify mild and severe LVD (LV ejection fraction [EF] 40{\%}-54{\%} and <40{\%}, respectively) in 3184 American Indians. Results: Mild and severe LVD were more common in men than women (17.4{\%} vs 7.2{\%} and 4.7{\%} vs 1.8{\%}) and in diabetic than nondiabetic participants (12.7{\%} vs 9.1{\%} and 3.5{\%} vs 1.6{\%}). Stepwise increases were observed from participants with normal EF to those with mild and severe LVD in age (mean 60 vs 61 and 63 years, P< .001), prevalence of overt CHF (2{\%} vs 6{\%} and 28{\%}) and definite coronary heart disease (3{\%} vs 11{\%} and 32{\%}), systolic pressure (129 vs 135 and 136 mm Hg), serum creatinine level (0.98 vs 1.34 and 2.16 mg/dL), and log urinary albumin/creatinine level (3.2 vs 3.7 and 4.7); a negative relation was seen with body mass index (31.1 vs 31.0 and 28.4 kg/m2) (all P< .001). In multivariate analyses lower LVEFs were independently associated with clinical CHF and coronary heart disease, lower myocardial contractility, male sex, hypertension, oveweight, arterial stiffening (higher pulse pressure/stroke volume) and renal dysfunction (higher serum creatinine level), higher LV mass, and lower relative wall thickness. Conclusion: LVD, present in approximately 14{\%} of middle-aged to elderly adults, is independently associated with overt heart failure and coronary heart disease, male sex, hypertension, overweight, arterial stiffening, and renal target organ damage and, less consistently, with older age and diabetes.",
author = "Devereux, {Richard B.} and Roman, {Mary J.} and Mary Paranicas and Lee, {Elisa T.} and Welty, {Thomas K.} and Fabsitz, {Richard R.} and David Robbins and Rhoades, {Everett R.} and Rodeheffer, {Richard J.} and Cowan, {Linda D.} and Howard, {Barbara V.}",
year = "2001",
doi = "10.1067/mhj.2001.113223",
language = "English (US)",
volume = "141",
pages = "439--446",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - A population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults

T2 - The Strong Heart Study

AU - Devereux, Richard B.

AU - Roman, Mary J.

AU - Paranicas, Mary

AU - Lee, Elisa T.

AU - Welty, Thomas K.

AU - Fabsitz, Richard R.

AU - Robbins, David

AU - Rhoades, Everett R.

AU - Rodeheffer, Richard J.

AU - Cowan, Linda D.

AU - Howard, Barbara V.

PY - 2001

Y1 - 2001

N2 - Background: Although clinical congestive heart failure (CHF) is increasingly common, few data document the prevalence and correlates of underlying left ventricular (LV) systolic dysfunction (D) in population-based samples. Methods: Echocardiography was used in the second Strong Heart Study (SHS) examination to identify mild and severe LVD (LV ejection fraction [EF] 40%-54% and <40%, respectively) in 3184 American Indians. Results: Mild and severe LVD were more common in men than women (17.4% vs 7.2% and 4.7% vs 1.8%) and in diabetic than nondiabetic participants (12.7% vs 9.1% and 3.5% vs 1.6%). Stepwise increases were observed from participants with normal EF to those with mild and severe LVD in age (mean 60 vs 61 and 63 years, P< .001), prevalence of overt CHF (2% vs 6% and 28%) and definite coronary heart disease (3% vs 11% and 32%), systolic pressure (129 vs 135 and 136 mm Hg), serum creatinine level (0.98 vs 1.34 and 2.16 mg/dL), and log urinary albumin/creatinine level (3.2 vs 3.7 and 4.7); a negative relation was seen with body mass index (31.1 vs 31.0 and 28.4 kg/m2) (all P< .001). In multivariate analyses lower LVEFs were independently associated with clinical CHF and coronary heart disease, lower myocardial contractility, male sex, hypertension, oveweight, arterial stiffening (higher pulse pressure/stroke volume) and renal dysfunction (higher serum creatinine level), higher LV mass, and lower relative wall thickness. Conclusion: LVD, present in approximately 14% of middle-aged to elderly adults, is independently associated with overt heart failure and coronary heart disease, male sex, hypertension, overweight, arterial stiffening, and renal target organ damage and, less consistently, with older age and diabetes.

AB - Background: Although clinical congestive heart failure (CHF) is increasingly common, few data document the prevalence and correlates of underlying left ventricular (LV) systolic dysfunction (D) in population-based samples. Methods: Echocardiography was used in the second Strong Heart Study (SHS) examination to identify mild and severe LVD (LV ejection fraction [EF] 40%-54% and <40%, respectively) in 3184 American Indians. Results: Mild and severe LVD were more common in men than women (17.4% vs 7.2% and 4.7% vs 1.8%) and in diabetic than nondiabetic participants (12.7% vs 9.1% and 3.5% vs 1.6%). Stepwise increases were observed from participants with normal EF to those with mild and severe LVD in age (mean 60 vs 61 and 63 years, P< .001), prevalence of overt CHF (2% vs 6% and 28%) and definite coronary heart disease (3% vs 11% and 32%), systolic pressure (129 vs 135 and 136 mm Hg), serum creatinine level (0.98 vs 1.34 and 2.16 mg/dL), and log urinary albumin/creatinine level (3.2 vs 3.7 and 4.7); a negative relation was seen with body mass index (31.1 vs 31.0 and 28.4 kg/m2) (all P< .001). In multivariate analyses lower LVEFs were independently associated with clinical CHF and coronary heart disease, lower myocardial contractility, male sex, hypertension, oveweight, arterial stiffening (higher pulse pressure/stroke volume) and renal dysfunction (higher serum creatinine level), higher LV mass, and lower relative wall thickness. Conclusion: LVD, present in approximately 14% of middle-aged to elderly adults, is independently associated with overt heart failure and coronary heart disease, male sex, hypertension, overweight, arterial stiffening, and renal target organ damage and, less consistently, with older age and diabetes.

UR - http://www.scopus.com/inward/record.url?scp=17744390545&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=17744390545&partnerID=8YFLogxK

U2 - 10.1067/mhj.2001.113223

DO - 10.1067/mhj.2001.113223

M3 - Article

C2 - 11231443

AN - SCOPUS:17744390545

VL - 141

SP - 439

EP - 446

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 3

ER -