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Epidemiology/Health Services/Psychosocial Research

Heart Failure Prevalence, Incidence, and Mortality in the Elderly With Diabetes

  1. Alain G. Bertoni, MD, MPH12,
  2. W. Gregory Hundley, MD2,
  3. Mark W. Massing, MD, PHD3,
  4. Denise E. Bonds, MD, MPH12,
  5. Gregory L. Burke, MD, MS1 and
  6. David C. Goff, Jr., MD, PHD12
  1. 1Department of Public Health Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
  2. 2Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
  3. 3Medical Review of North Carolina, Cary, North Carolina
  1. Address correspondence and reprint requests to Dr. Alain Bertoni, Public Health Sciences, Medical Center Boulevard, Winston-Salem, NC 27157. E-mail: abertoni{at}wfubmc.edu
Diabetes Care 2004 Mar; 27(3): 699-703. https://doi.org/10.2337/diacare.27.3.699
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    Figure 1—

    Five-year Kaplan-Meier survival estimates for 115,803 adults age ≥65 years in fee-for-service Medicare with diabetes by incident heart failure status.

Tables

  • Figures
  • Table 1—

    Baseline characteristics of study population with diabetes in Medicare in 1994 by heart failure status

    Cohort in 1994No heart failurePrevalent heart failure
    n117,93333,805
    Age (years)73.8 ± 6.476.3 ± 7.1
    Woman59.461.8
    White race*84.083.7
    Black race*11.812.0
    Other/missing race*4.24.3
    Dual eligible15.323.7
    Hypertension59.868.1
    Ischemic heart disease30.467.4
    Peripheral vascular disease17.830.1
    Stroke/transient ischemic attack15.328.6
    Nephropathy4.016.4
    End-stage renal disease0.42.2
    Retinopathy14.617.3
    Neuropathy14.019.6
    Metabolic acidosis/coma4.06.1
    Hypoglycemia2.34.6
    • Data are % and mean ± SD. Dual eligible persons qualify for Medicaid coverage. All comparisons are significant at P < 0.001 except for

    • *

      ↵* those that are not significant.

  • Table 2—

    Prevalence of heart failure in 1994 among adults with diabetes aged ≥65 years in Medicare and incidence of heart failure during 1995–1999 among those free of heart failure in 1994

    Demographic groupPrevalent heart failure in 1994Incident heart failure during 1995–1999
    n151,738115,803
    All22.312.6
    Men21.212.5
    Women23.012.7
    Whites22.412.8
    Blacks22.612.8
    Age 65–69 years15.78.4
    Age 70–74 years19.69.8
    Age 75–79 years23.812.2
    Age 80–84 years29.615.8
    Age ≥85 years37.420.5
    • Data are % (prevalence) or rate per 100 person-years (incidence) by demographic group.

  • Table 3—

    Association between selected baseline demographic characteristics and comorbidities with prevalent and incident heart failure among adults with diabetes aged ≥65 years

    CharacteristicsPrevalent heart failure in 1994
    Incident heart failure during 1995–1999
    OR95% CIHR95% CI
    n151,738115,803
    Women1.101.07–1.130.960.94–0.98
    5-year age interval1.281.27–1.291.231.22–1.24
    Black (vs. white)0.940.90–0.980.950.92–0.98
    Other race (vs. white)0.840.79–0.890.800.76–0.84
    Dual eligible1.511.45–1.561.301.26–1.33
    South (vs. Northeast)1.061.02–1.10.97*0.94–0.99
    Midwest (vs. Northeast)1.141.10–1.191.03*1.01–1.06
    West (vs. Northeast)1.151.10–1.200.950.92–0.98
    Ischemic heart disease4.144.03–4.261.621.59–1.66
    Hypertension1.211.18–1.251.101.07–1.12
    Stroke/TIA1.401.35–1.441.241.20–1.27
    Peripheral vascular disease1.361.32–1.411.251.22–1.28
    Nephropathy3.513.34–3.681.531.46–1.59
    End-stage renal disease1.431.25–1.631.991.77–2.24
    Metabolic acidosis/coma1.171.1–1.241.111.06–1.16
    Hypoglycemia1.371.28–1.481.151.08–1.21
    Amputation1.371.22–1.550.99†0.89–1.10
    Retinopathy1.111.07–1.161.251.22–1.29
    Neuropathy1.121.08–1.161.161.13–1.19
    • Results presented are from multivariate logistic (prevalence) and proportional hazards (incidence) models including all characteristics listed in the table. TIA, transient ischemic attack. All P values are <0.001, except

    • *

      ↵* P < 0.05 and

    • †

      † not significant.

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Diabetes Care: 27 (3)

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Heart Failure Prevalence, Incidence, and Mortality in the Elderly With Diabetes
Alain G. Bertoni, W. Gregory Hundley, Mark W. Massing, Denise E. Bonds, Gregory L. Burke, David C. Goff
Diabetes Care Mar 2004, 27 (3) 699-703; DOI: 10.2337/diacare.27.3.699

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Heart Failure Prevalence, Incidence, and Mortality in the Elderly With Diabetes
Alain G. Bertoni, W. Gregory Hundley, Mark W. Massing, Denise E. Bonds, Gregory L. Burke, David C. Goff
Diabetes Care Mar 2004, 27 (3) 699-703; DOI: 10.2337/diacare.27.3.699
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