Allostatic load and incident heart failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study
Abstract Background Allostatic load (AL) is the physiologic “wear and tear” on the body from stress. Yet, despite stress being implicated in the development heart failure (HF), it is unknown whether AL is associated with incident HF events. Methods We examined 16,765 participants without HF at basel...
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-023-03371-z |
| _version_ | 1797784793750962176 |
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| author | Christine Park Joanna B. Ringel Laura C. Pinheiro Alanna A. Morris Madeline Sterling Lauren Balkan Samprit Banerjee Emily B. Levitan Monika M. Safford Parag Goyal |
| author_facet | Christine Park Joanna B. Ringel Laura C. Pinheiro Alanna A. Morris Madeline Sterling Lauren Balkan Samprit Banerjee Emily B. Levitan Monika M. Safford Parag Goyal |
| author_sort | Christine Park |
| collection | DOAJ |
| description | Abstract Background Allostatic load (AL) is the physiologic “wear and tear” on the body from stress. Yet, despite stress being implicated in the development heart failure (HF), it is unknown whether AL is associated with incident HF events. Methods We examined 16,765 participants without HF at baseline from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. The main exposure was AL score quartile. AL was determined according to 11 physiologic parameters, whereby each parameter was assigned points (0–3) based on quartiles within the sample, and points were summed to create a total AL score ranging from 0–33. The outcome was incident HF event. We examined the association between AL quartile (Q1-Q4) and incident HF events using Cox proportional hazards models, adjusted for demographics, socioeconomic factors, and lifestyle. Results The mean age was 64 ± 9.6 years, 61.5% were women, and 38.7% were Black participants. Over a median follow up of 11.4 years, we observed 750 incident HF events (635 HF hospitalizations and 115 HF deaths). Compared to the lowest AL quartile (Q1), the fully adjusted hazards of an incident HF event increased in a graded fashion: Q2 HR 1.49 95% CI 1.12–1.98; Q3 HR 2.47 95% CI 1.89–3.23; Q4 HR 4.28 95% CI 3.28–5.59. The HRs for incident HF event in the fully adjusted model that also adjusted for CAD were attenuated, but remained significant and increased in a similar, graded fashion by AL quartile. There was a significant age interaction (p-for-interaction < 0.001), whereby the associations were observed across each age stratum, but the HRs were highest among those aged < 65 years. Conclusion AL was associated with incident HF events, suggesting that AL could be an important risk factor and potential target for future interventions to prevent HF. |
| first_indexed | 2024-03-13T00:44:57Z |
| format | Article |
| id | doaj.art-d41cc78d73e440f4aa212c56b3caaca8 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-03-13T00:44:57Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-d41cc78d73e440f4aa212c56b3caaca82023-07-09T11:05:37ZengBMCBMC Cardiovascular Disorders1471-22612023-07-0123111110.1186/s12872-023-03371-zAllostatic load and incident heart failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) studyChristine Park0Joanna B. Ringel1Laura C. Pinheiro2Alanna A. Morris3Madeline Sterling4Lauren Balkan5Samprit Banerjee6Emily B. Levitan7Monika M. Safford8Parag Goyal9Department of Medicine, New York Presbyterian-Weill CornellDivision of General Internal Medicine, Department of Medicine, Weill Cornell MedicineDivision of General Internal Medicine, Department of Medicine, Weill Cornell MedicineDepartment of Medicine, Emory University School of MedicineDivision of General Internal Medicine, Department of Medicine, Weill Cornell MedicineDepartment of Cardiology, Beth Israel Deaconess Medical CenterDivision of Biostatistics and Epidemiology, Department of Public Health, Weill Medical College of Cornell UniversityDepartment of Epidemiology, University of Alabama at BirminghamDivision of General Internal Medicine, Department of Medicine, Weill Cornell MedicineDepartment of Medicine, New York Presbyterian-Weill CornellAbstract Background Allostatic load (AL) is the physiologic “wear and tear” on the body from stress. Yet, despite stress being implicated in the development heart failure (HF), it is unknown whether AL is associated with incident HF events. Methods We examined 16,765 participants without HF at baseline from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. The main exposure was AL score quartile. AL was determined according to 11 physiologic parameters, whereby each parameter was assigned points (0–3) based on quartiles within the sample, and points were summed to create a total AL score ranging from 0–33. The outcome was incident HF event. We examined the association between AL quartile (Q1-Q4) and incident HF events using Cox proportional hazards models, adjusted for demographics, socioeconomic factors, and lifestyle. Results The mean age was 64 ± 9.6 years, 61.5% were women, and 38.7% were Black participants. Over a median follow up of 11.4 years, we observed 750 incident HF events (635 HF hospitalizations and 115 HF deaths). Compared to the lowest AL quartile (Q1), the fully adjusted hazards of an incident HF event increased in a graded fashion: Q2 HR 1.49 95% CI 1.12–1.98; Q3 HR 2.47 95% CI 1.89–3.23; Q4 HR 4.28 95% CI 3.28–5.59. The HRs for incident HF event in the fully adjusted model that also adjusted for CAD were attenuated, but remained significant and increased in a similar, graded fashion by AL quartile. There was a significant age interaction (p-for-interaction < 0.001), whereby the associations were observed across each age stratum, but the HRs were highest among those aged < 65 years. Conclusion AL was associated with incident HF events, suggesting that AL could be an important risk factor and potential target for future interventions to prevent HF.https://doi.org/10.1186/s12872-023-03371-zAllostatic loadHeart failureOutcomes |
| spellingShingle | Christine Park Joanna B. Ringel Laura C. Pinheiro Alanna A. Morris Madeline Sterling Lauren Balkan Samprit Banerjee Emily B. Levitan Monika M. Safford Parag Goyal Allostatic load and incident heart failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study BMC Cardiovascular Disorders Allostatic load Heart failure Outcomes |
| title | Allostatic load and incident heart failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study |
| title_full | Allostatic load and incident heart failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study |
| title_fullStr | Allostatic load and incident heart failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study |
| title_full_unstemmed | Allostatic load and incident heart failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study |
| title_short | Allostatic load and incident heart failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study |
| title_sort | allostatic load and incident heart failure in the reasons for geographic and racial differences in stroke regards study |
| topic | Allostatic load Heart failure Outcomes |
| url | https://doi.org/10.1186/s12872-023-03371-z |
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