Regional and ethnic differences among patients with heart failure in Asia: The Asian sudden cardiac death in heart failure registry

Carolyn S.P. Lam, Tiew Hwa Katherine Teng, Wan Ting Tay, Inder Anand, Shu Zhang, Wataru Shimizu, Calambur Narasimhan, Sang Weon Park, Cheuk Man Yu, Tachapong Ngarmukos, Razali Omar, Eugene B. Reyes, Ambang B. Siswanto, Chung Lieh Hung, Lieng H. Ling, Jonathan Yap, Michael MacDonald, A. Mark Richards

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74 Scopus citations

Abstract

Aims To characterize regional and ethnic differences in heart failure (HF) across Asia. Methods and results We prospectively studied 5276 patients with stable HF and reduced ejection fraction (≤40%) from 11 Asian regions (China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan, and Thailand). Mean age was 59.6+13.1 years, 78.2% were men, and mean body mass index was 24.9+5.1 kg/m2. Majority (64%) of patients had two or more comorbid conditions such as hypertension (51.9%), coronary artery disease (CAD, 50.2%), or diabetes (40.4%). The prevalence of CAD was highest in Southeast Asians (58.8 vs. 38.2% in Northeast Asians). Compared with Chinese ethnicity, Malays (adjusted odds ratio [OR] 1.97, 95% CI 1.63-2.38) and Indians (OR 1.44, 95% CI 1.24-1.68) had higher odds of CAD, whereas Koreans (OR 0.38, 95% CI 0.29-0.50) and Japanese (OR 0.44, 95% CI 0.36-0.55) had lower odds. The prevalence of hypertension and diabetes was highest in Southeast Asians (64.2 and 49.3%, respectively) and high-income regions (59.7 and 46.2%, respectively). There was significant interaction between ethnicity and region, where the adjusted odds were 3.95 (95% CI 2.51-6.21) for hypertension and 4.91 (95% CI 3.07-7.87) for diabetes among Indians from high- vs. low-income regions; and 2.60 (95% CI 1.66-4.06) for hypertension and 2.62 (95% CI 1.73-3.97) for diabetes among Malays from high- vs. low-income regions. Conclusions These first prospective multi-national data from Asia highlight the significant heterogeneity among Asian patients with stable HF, and the important influence of both ethnicity and regional income level on patient characteristics. ClinicalTrials.gov identifier NCT01633398.

Original languageEnglish (US)
Pages (from-to)3141-3153
Number of pages13
JournalEuropean Heart Journal
Volume37
Issue number41
DOIs
StatePublished - Jan 1 2016

Keywords

  • Asia
  • Epidemiology
  • Ethnicity
  • Heart failure
  • Risk factors

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