Association of Kidney Function With Incident Heart Failure: An Analysis of the Women's Health Initiative
Background Studies have shown an association of chronic kidney disease with heart failure (HF); however, this association has not been adequately examined in postmenopausal women, who are at heightened risk of both chronic kidney disease and HF. Additionally, association with HF subtypes is not well...
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Wiley
2025-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037051 |
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| author | Richard K. Cheng Mary B. Roberts Nisha Bansal Kerryn Reding Taufiq Salahuddin Mamas Mamas Michael LaMonte Aladdin H. Shadyab Nora Franceschini Liviu Klein JoAnn E. Manson Charles B. Eaton |
| author_facet | Richard K. Cheng Mary B. Roberts Nisha Bansal Kerryn Reding Taufiq Salahuddin Mamas Mamas Michael LaMonte Aladdin H. Shadyab Nora Franceschini Liviu Klein JoAnn E. Manson Charles B. Eaton |
| author_sort | Richard K. Cheng |
| collection | DOAJ |
| description | Background Studies have shown an association of chronic kidney disease with heart failure (HF); however, this association has not been adequately examined in postmenopausal women, who are at heightened risk of both chronic kidney disease and HF. Additionally, association with HF subtypes is not well characterized. Methods and Results Incident HF was defined as first hospitalization for acute decompensated HF, obtained by self‐reported outcomes followed by physician adjudication through review of hospital records. Chronic kidney disease was defined using estimated glomerular filtration rate (eGFR). Restricted cubic splines tested the association of eGFR with incident overall HF, and HF with reduced ejection fraction (HFrEF) and preserved EF (HFpEF). Cox proportional hazards regression models evaluated the multivariable‐adjusted association of eGFR categories with incident HF and its subtypes. The primary analysis included 23 309 women with 11 814 eGFR ≥90, 10 191 eGFR between 60 and 89, 1048 eGFR between 45 and 59 and 256 eGFR <45 mL/min per 1.73 m2. For overall HF, HFrEF and HFpEF, there was a stepwise increase in risk for incident HF with declining eGFR category. Associations were stronger for HFpEF (hazard ratio [HR], 2.80 [95% CI, 2.36–3.32]) than for HFrEF (HR, 2.18 [95% CI, 1.66–2.87]) for eGFR <45 as compared with eGFR ≥90. Heterogeneity of the HF subdistributions (HFpEF versus HFrEF) was significant (P=0.017). Conclusions Kidney dysfunction is associated with incident HF in postmenopausal women. Although lower eGFR is associated with both incident HFrEF and HFpEF, the association is stronger with HFpEF. Registration URL: https://clinicaltrials.gov; Unique Identifier: NCT00000611. |
| format | Article |
| id | doaj-art-17fd39ece3e94bd099aac6dee0ab47d7 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-17fd39ece3e94bd099aac6dee0ab47d72025-08-20T02:12:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114510.1161/JAHA.124.037051Association of Kidney Function With Incident Heart Failure: An Analysis of the Women's Health InitiativeRichard K. Cheng0Mary B. Roberts1Nisha Bansal2Kerryn Reding3Taufiq Salahuddin4Mamas Mamas5Michael LaMonte6Aladdin H. Shadyab7Nora Franceschini8Liviu Klein9JoAnn E. Manson10Charles B. Eaton11Division of Cardiology, Department of Medicine University of Washington Seattle WA USACenter for Primary Care and Prevention Kent Hospital Pawtucket RI USADivision of Nephrology, Department of Medicine University of Washington Seattle WA USADepartment of Biobehavioral Nursing and Health Informatics, School of Nursing University of Washington Seattle WA USADivision of Cardiology, Department of Medicine University of Washington Seattle WA USADivision of Cardiology Keele University Keele UKDepartment of Epidemiology, School of Public Health and Health Professions University at Buffalo – SUNY Buffalo NY USAHerbert Wertheim School of Public Health and Human Longevity Science University of California San Diego, La Jolla CA USADepartment of Epidemiology University of North Carolina Chapel Hill NC USADivision of Cardiology, Department of Medicine University of California San Francisco San Francisco CA USADivision of Preventive Medicine Brigham and Women’s Hospital, Harvard Medical School Boston MA USACenter for Primary Care and Prevention Kent Hospital Pawtucket RI USABackground Studies have shown an association of chronic kidney disease with heart failure (HF); however, this association has not been adequately examined in postmenopausal women, who are at heightened risk of both chronic kidney disease and HF. Additionally, association with HF subtypes is not well characterized. Methods and Results Incident HF was defined as first hospitalization for acute decompensated HF, obtained by self‐reported outcomes followed by physician adjudication through review of hospital records. Chronic kidney disease was defined using estimated glomerular filtration rate (eGFR). Restricted cubic splines tested the association of eGFR with incident overall HF, and HF with reduced ejection fraction (HFrEF) and preserved EF (HFpEF). Cox proportional hazards regression models evaluated the multivariable‐adjusted association of eGFR categories with incident HF and its subtypes. The primary analysis included 23 309 women with 11 814 eGFR ≥90, 10 191 eGFR between 60 and 89, 1048 eGFR between 45 and 59 and 256 eGFR <45 mL/min per 1.73 m2. For overall HF, HFrEF and HFpEF, there was a stepwise increase in risk for incident HF with declining eGFR category. Associations were stronger for HFpEF (hazard ratio [HR], 2.80 [95% CI, 2.36–3.32]) than for HFrEF (HR, 2.18 [95% CI, 1.66–2.87]) for eGFR <45 as compared with eGFR ≥90. Heterogeneity of the HF subdistributions (HFpEF versus HFrEF) was significant (P=0.017). Conclusions Kidney dysfunction is associated with incident HF in postmenopausal women. Although lower eGFR is associated with both incident HFrEF and HFpEF, the association is stronger with HFpEF. Registration URL: https://clinicaltrials.gov; Unique Identifier: NCT00000611.https://www.ahajournals.org/doi/10.1161/JAHA.124.037051chronic kidney diseaseheart failureHFpEF |
| spellingShingle | Richard K. Cheng Mary B. Roberts Nisha Bansal Kerryn Reding Taufiq Salahuddin Mamas Mamas Michael LaMonte Aladdin H. Shadyab Nora Franceschini Liviu Klein JoAnn E. Manson Charles B. Eaton Association of Kidney Function With Incident Heart Failure: An Analysis of the Women's Health Initiative Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease chronic kidney disease heart failure HFpEF |
| title | Association of Kidney Function With Incident Heart Failure: An Analysis of the Women's Health Initiative |
| title_full | Association of Kidney Function With Incident Heart Failure: An Analysis of the Women's Health Initiative |
| title_fullStr | Association of Kidney Function With Incident Heart Failure: An Analysis of the Women's Health Initiative |
| title_full_unstemmed | Association of Kidney Function With Incident Heart Failure: An Analysis of the Women's Health Initiative |
| title_short | Association of Kidney Function With Incident Heart Failure: An Analysis of the Women's Health Initiative |
| title_sort | association of kidney function with incident heart failure an analysis of the women s health initiative |
| topic | chronic kidney disease heart failure HFpEF |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037051 |
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