Epidemiology of Congestive Heart Failure in Three Ethnic Groups

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Abstract
Congestive heart failure (CHF) is a leading cause of morbidity, disability, and mortality in old age, but little is known about the epidemiology of this condition in free‐living minority populations. To determine the prevalence of CHF and associated risk factors in a multiethnic community, a population sample of 2759 elderly (i.e., 65 years of age and older) African American (AA), Hispanic‐Cuban (HC), and white non‐Hispanic (WNH) men and women from Miami‐Dade County, Florida, were examined. There were 153 (5.6%) cases of self‐reported CHF in the sample. The unadjusted prevalence rate of CHF was virtually identical among elderly AA (4.8%) and WNH (4.9%) but was significantly (p=0.04) lower than the rate among HC (6.8%). Sex‐ and ethnic‐specific analyses showed that the highest prevalence rate of CHF was among HC women (8.2%). A multiple logistic analysis was used to calculate the odds ratio (OR) and 95% confidence interval (CI) of CHF in relation to age, sex, ethnicity, medical history, and smoking and alcohol drinking habits. Age (65–74 vs. 75–84, OR 1.7, CI 1.2–2.4, p=0.01), HC ethnic group (OR 1.5, CI 1.0–2.4, p=0.05), history of hypertension (OR 1.5, CI 1.1–2.1, p=0.02), history of myocardial infarction (OR 2.3, CI 1.5–3.5, p=0.0001), and history of diabetes mellitus (OR 1.9, CI 1.3–2.8, p=0.001) were directly, significantly, and independently associated with the prevalence of self‐reported CHF. The findings here confirm those of prior studies in elderly white U.S. residents, which indicate that heart attack, hypertension, and diabetes mellitus are major risk factors for CHF. The results also show that elderly AA and WNH have similar CHF prevalence rates. The higher CHF prevalence in elderly HC women found in this study requires further investigation.