Sex- and age-specific differences in the associations between comorbidity and incident heart failure

Little evidence exists regarding the sex- and age-specific differences in the associations of comorbidities and incident heart failure (HF). This study aims to evaluate the sex- and age-specific associations of comorbidities and incident HF, and further calculate the population attributable fractions (PAFs) of comorbid diseases for HF by sex and age. Data were from a sub-cohort of the Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project from Southern China. Participants were stratified by sex and by age (<60 or ≥ 60). The seven comorbidities were collected at baseline, and the study outcome was HF-related hospitalization identified from the Inpatients Registry. A total of 102,278 participants (mean age: 54.3 years, 60.5% were women) without prevalent HF were included. After a median follow-up of 3.5 years, 1,588 participants had incident HF. Men, older age (≥60 years), and most comorbidities were significantly associated with a higher risk of HF. The associations between several comorbidities with incident HF were more prominent in women and young participants aged <60 than in men and seniors. The seven comorbidities collectively explained a significant proportion of population attributable fraction (PAF) for HF (47.1%, 95% confidence interval: 41.4, 52.2), and several sex- and age-specific differences in PAFs of comorbidities for incident HF were also observed. In this large, prospective cohort study, several sex- and age-specific differences in the associations between common comorbidities and incident HF were found among Chinese general adults, highlighting the importance of sex- and age-specific preventive strategies for HF.