![]() P-values from Gray’s test for equality of cumulative incidence functions are shown on the plots. ( C) Cumulative incidence functions for heart failure accounting for competing mortality plotted separately for each group. % of heart failure cases in each group are shown above each histogram. Groups identified by CART algorithm are shown in different colours. ( B) Histograms showing distributions of the study participants according to tested variables. ( A) Examples of CART algorithm outcome for group splitting based on sodium and tonicity 1 (2 + /18). Cumulative heart failure incidence at the end of follow-up was used as outcome variable for the splitting algorithms. CART algorithm was used to split study participants into groups based on hydration-related variables that showed significant association with HF in Fine–Gray models shown in Figure 2. Study participants can be divided into groups with significantly different cumulative incidence functions for heart failure if divisions are based on sodium, water deficit or tonicity. See Supplementary material online, Figure S1 for distribution histograms related to haematocrit and Supplementary material online, Tables S2–S5 for full models results. Lower panels show distribution histograms for the exposure variables used in the models. See Supplementary material online, Tables S2–S5 for full models results. The models were run with the same covariates as used in serum sodium model shown in ( B). ( C) Hazard ratios for exposure variables related to hydration and salt intake resulting from Fine–Gray subdistribution PH models for risk of heart failure. Lower panels show distribution histograms for continuous variables used in the model. High blood pressure is defined as systolic blood pressure >140 mm Hg or diastolic blood pressure >90 mm Hg. Categorical variable adjusting for blood pressure status contains four categories taking into account blood pressure measured values and use of blood pressure medications. no smoking as reference used as categorical covariates, as well as body mass index, total cholesterol and estimated glomerular filtration rate used as continuous covariates. ![]() The model is adjusted for age as continuous variable and for heart failure risk factors: sex-male vs. ( B) Higher serum sodium within normal range of 135–146 mmol/L is associated with increased risk to develop heart failure. ( A) The cumulative incidence functions for heart failure and for mortality not related to heart failure over 25 years of follow-up in ARIC study participants. Metrics of reduced hydration assessed at middle age are associated with increased risk to develop heart failure. This work is written by (a) US Government employee(s) and is in the public domain in the US. Published by Oxford University Press on behalf of European Society of Cardiology 2022. Heart failure Hydration Left ventricular hypertrophy Prevention Risk factors Sodium. Maintaining good hydration throughout life may slow down decline in cardiac function and decrease prevalence of HF. Middle age serum sodium above 142 mmol is a risk factor for LVH and HF. As a result, prevalence of HF and LVH was increased among 70- to 90-year-old participants with higher middle age serum sodium. Serum sodium above 143 mmol/L was associated with 107% increase in odds of LVH (OR 2.07, 95% CI 1.30-3.28) and 54% increase in odds of HF (OR 1.54, 95% CI 1.06-2.23). In a retrospective case-control analysis performed on 70- to 90-year-old attendees of Visit 5 (N = 4961), serum sodium of 142.5-143 mmol/L was associated with 62% increase in odds of left ventricular hypertrophy (LVH) diagnosis. In time-to-event analysis, HF risk was increased by 39% if middle age serum sodium exceeded 143 mmol/L corresponding to 1% body weight water deficit. Participants without water balance dysregulation were selected: serum sodium within normal range (135-146 mmol/L), not diabetic, not obese and free of HF at baseline (N = 11 814). We analysed data from Atherosclerosis Risk in Communities study with middle age enrolment (45-66 years) and 25 years of follow-up. Here, we evaluate the association of serum sodium at middle age as a measure of hydration habits with risk to develop HF. In a mouse model, chronic hypohydration induced by lifelong water restriction promotes cardiac fibrosis. With increasing prevalence of heart failure (HF) owing to the ageing population, identification of modifiable risk factors is important.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |