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BMC Geriatrics

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Open Access 01-12-2023 | Heart Failure | Research

Association between allostatic load and adverse outcomes among older patients with heart failure with preserved ejection fraction

Authors: Benchuan Hao, Jianqiao Chen, Yulun Cai, Huiying Li, Zifan Zhu, Weihao Xu, Hongbin Liu

Published in: BMC Geriatrics | Issue 1/2023

Abstract

Background

The allostatic load (AL) refers to the cumulative weakening of multiple physiological systems caused by repeated adaptation of the body to stressors There are still no studies have focused on the association between AL and the prognosis of patients with heart failure with preserved ejection fraction (HFpEF). The present study aimed to investigate the association between AL and adverse outcomes, including mortality and HF admission, among elderly male patients with HFpEF.

Methods

We conducted a prospective cohort study of 1111 elderly male patients with HFpEF, diagnosed between 2015 and 2019 and followed up through 2021. We constructed an AL measure using a combination of 12 biomarkers. The diagnosis of HFpEF was made according to the 2021 European Society of Cardiology guidelines. A Cox proportional hazards model was used to determine the associations between AL and adverse outcomes.

Results

In multivariate analysis, AL was significantly associated with increased risk of all-cause mortality (medium AL: adjusted hazard ratio [HR] = 2.53; 95% confidence interval [CI] 1.37–4.68; high AL: HR = 4.21; 95% CI 2.27–7.83; per-score increase: HR = 1.31; 95% CI 1.18–1.46), cardiovascular mortality (medium AL: HR = 2.67; 95% CI 1.07–6.68; high AL: HR = 3.13; 95% CI 1.23–7.97; per-score increase: HR = 1.20; 95% CI 1.03–1.40), non-cardiovascular mortality (medium AL: HR = 2.45; 95% CI 1.06–5.63; high AL: HR = 5.81; 95% CI 2.55–10.28; per-score increase: HR = 1.46; 95% CI 1.26–1.69), and HF admission (medium AL: HR = 2.68; 95% CI 1.43–5.01; high AL: HR = 3.24; 95% CI 1.69–6.23; per-score increase: HR = 1.24; 95% CI 1.11–1.39). Consistent results were found in multiple subgroup analyses.

Conclusions

A higher AL was associated with poor prognosis in elderly men with HFpEF. AL relies on information that is easily obtained in physical examinations and laboratory parameters and can be assessed in various care and clinical settings to help risk stratification of HFpEF patients.

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Title: Association between allostatic load and adverse outcomes among older patients with heart failure with preserved ejection fraction
Authors: Benchuan Hao
Jianqiao Chen
Yulun Cai
Huiying Li
Zifan Zhu
Weihao Xu
Hongbin Liu
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Heart Failure
Published in: BMC Geriatrics / Issue 1/2023
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-023-04091-x

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