Prevalence and clinical significance of diabetes in asian versus white patients with heart failure
Open accessAbstract
Objectives The study sought to compare the prevalence, clinical correlates and prognostic impact of diabetes in Southeast Asian versus white patients with heart failure (HF) with preserved or reduced ejection fraction.Background Diabetes mellitus is common in HF and is associated with impaired prognosis. Asia is home to the majority of the world's diabetic population, yet data on the prevalence and clinical significance of diabetes in Asian patients with HF are sparse, and no studies have directly compared Asian and white patients.Methods Two contemporary population-based HF cohorts were combined: from Singapore (n = 1,002, median [25th to 75th percentile] age 62 [54 to 70] years, 76% men, 19.5% obesity) and Sweden (n = 19,537, 77 [68 to 84] years, 60% men, 24.8% obesity). The modifying effect of ethnicity on the relationship between diabetes and clinical correlates or prognosis (HF hospitalization and all-cause mortality) was examined using interaction terms.Results Diabetes was present in 569 (57%) Asian patients versus 4,680 (24%) white patients (p < 0.001). Adjusting for clinical covariates, obesity was more strongly associated with diabetes in white patients (odds ratio [OR]: 3.45; 95% confidence interval [CI]: 2.86 to 4.17) than in Asian patients (OR: 1.82; 95% CI: 1.13 to 2.96; p interaction = 0.026). Diabetes was more strongly associated with increased HF hospitalization and all-cause mortality in Asian patients (hazard ratio: 1.50; 95% CI: 1.21 to 1.87) than in white patients (hazard ratio: 1.29; 95% CI: 1.22 to 1.36; p interaction = 0.045).Conclusions Diabetes was 3-fold more common in Southeast Asian compared to white patients with HF, despite younger age and less obesity, and more strongly associated with poor outcomes in Asian patients than white patients. These results underscore the importance of ethnicity-tailored aggressive strategies to prevent diabetes and its complications.
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A significantly higher prevalence of T2DM (57%) was observed in a population-based cohort of Southeast Asian HF patients compared to Caucasian patients (24%).
“Despite younger age and less obesity, a significantly higher prevalence of T2DM (57%) was observed in a population-based cohort of Southeast Asian HF patients compared to Caucasian patients (24%).30”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [30]
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2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
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- Authors
- Bank, I. E. M., Gijsberts, C. M., Teng, T.-H. K., Benson, L., Sim, D., Yeo, P. S. D., Ong, H. Y., Jaufeerally, F., Leong, G. K. T., Ling, L. H., Richards, A. M., de Kleijn, D. P. V., Dahlström, U., Lund, L. H., & Lam, C. S. P.
- Affiliations
- University Medical Center Utrecht (NL)
- SingHealth (SG)
- Karolinska Institutet (SE)
- Tan Tock Seng Hospital (SG)
- Khoo Teck Puat Hospital (SG)
- Singapore General Hospital (SG)
- Changi General Hospital (SG)
- National University of Singapore (SG)
- Linköping University (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Lund, Lars H.
- Lam, Carolyn S.P.
- ORCID
- Venue
- JACC Heart Failure
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 5
- Issue
- 1
- Pages
- 14-24
- ISSN
- 2213-1779 (ISSN-L)
- OpenAlex
- W2562509504
- Cited by
- 87
- References
- 34
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 6 · 2023: 11 · 2022: 7 · 2021: 16 · 2020: 8 · 2019: 14 · 2018: 9 · 2017: 2
- FWCI
- 6.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- JACC Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Funders
- Koninklijke Nederlandse Akademie van Wetenschappen
- Hjärt-Lungfonden (20120321, 20100419)
- Karolinska Institutet
- Stockholms Läns Landsting (20,140,220, 20,110,120)
- Vetenskapsrådet (2013–23,897–104,604-23)
- Sveriges Kommuner och Landsting
- Medical Research Council
- National Medical Research Council
- Socialstyrelsen
- Biomedical Research Council
- Netherlands Heart Institute
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- diabetes mellitus, heart failure, heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, ethnic differences, Asian patients, Caucasian patients, obesity, diabetes prevalence, heart failure hospitalization, all-cause mortality, prognosis
- MeSH terms
- Aged, Aged, 80 and over, Diabetes Mellitus, Female, Heart Failure, Humans, Male, Middle Aged, Singapore, Stroke Volume, Sweden, Cohort Studies, Prevalence, White People, Asian People
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