Anemia and new-onset congestive heart failure in the general medicare population

Background: Anemia is associated with disease severity and prognosis for patients with congestive heart failure (CHF). It is unknown whether anemia is associated with the development of new-onset CHF in the elderly. Methods and Results: This retrospective longitudinal cohort study used the Medicare 5% database. In the incident analysis, the study sample comprised subjects without CHF in 1999 (n = 1,063,495); the main exposure variable evaluated was the presence or absence of anemia in 1999; and the primary study outcome was the occurrence of new-onset CHF. The prevalence of chronic anemia and CHF in 1999 was 5.0% and 9.9%, respectively. The incidence of new-onset CHF in 2000 in those with and those without anemia in 1999 was 12.3% and 5.9%, respectively, corresponding to an adjusted hazard ratio of 1.29 (P <. 001), a value intermediate between the hazard ratios of 1.13 (P <. 001), and 1.76 (P <. 001) associated with hypertension and atherosclerotic heart disease, respectively. Anemia also was associated with death in the year after new-onset CHF (adjusted hazard ratio, 1.28; P <. 001). Conclusion: Anemia in the Medicare population is associated with the diagnosis and prognosis of new-onset CHF.