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Abstract：
BACKGROUND: Evidence regarding sex differences in the associations of traditional risk factors with incident heart failure (HF) hospitalization among Chinese general adults is insufficient. This study aimed to evaluate the potential sex differences in the associations of traditional risk factors with HF among Chinese general adults.
RESULTS: Data were from a subcohort of the China PEACE (Patient-Centered Evaluative Assessment of Cardiac Events) Million Persons Project. The traditional risk factors 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; 39.5% men) without prevalent HF were recruited. A total of 1588 cases of HF-related hospitalization were captured after a median follow-up of 3.52 years. The incidence rates were significantly higher in men (2.1%) than in women (1.2%). However, the observed lower risk of HF in women was significantly attenuated or even vanished when several traditional risk factors were poorly controlled (P for sex-by-risk factors <0.05). The selected 11 risk factors collectively explained 62.5% (95% CI, 55.1-68.8) of population attributable fraction for HF in women, which is much higher than in men (population attributable fraction, 39.6% [95% CI, 28.5-48.9]).
CONCLUSIONS: Although women had a lower incidence rate of hospitalization for HF than men in this study, the risk for HF increased more remarkably in women than in men when several traditional risk factors were poorly controlled. This study suggests that intensive preventative strategies are immediately needed in China.
RESULTS: Data were from a subcohort of the China PEACE (Patient-Centered Evaluative Assessment of Cardiac Events) Million Persons Project. The traditional risk factors 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; 39.5% men) without prevalent HF were recruited. A total of 1588 cases of HF-related hospitalization were captured after a median follow-up of 3.52 years. The incidence rates were significantly higher in men (2.1%) than in women (1.2%). However, the observed lower risk of HF in women was significantly attenuated or even vanished when several traditional risk factors were poorly controlled (P for sex-by-risk factors <0.05). The selected 11 risk factors collectively explained 62.5% (95% CI, 55.1-68.8) of population attributable fraction for HF in women, which is much higher than in men (population attributable fraction, 39.6% [95% CI, 28.5-48.9]).
CONCLUSIONS: Although women had a lower incidence rate of hospitalization for HF than men in this study, the risk for HF increased more remarkably in women than in men when several traditional risk factors were poorly controlled. This study suggests that intensive preventative strategies are immediately needed in China.
摘要：
背景：关于中国普通成年人中传统危险因素与心力衰竭（HF）住院相关的性别差异的证据不足。本研究旨在评估中国普通成年人中传统危险因素与HF的潜在性别差异。
结果：数据来自中国PEACE（以患者为中心的心脏事件评估）百万人项目的一个子队列。在基线时收集传统的危险因素，研究结果为住院患者登记处确定的HF相关住院。共有102278名参与者(平均年龄，54.3年；39.5%的男性）没有普遍的HF被招募。在中位随访3.52年后，共捕获了1588例HF相关住院病例。男性的发病率（2.1％）明显高于女性（1.2％）。然而,在几个传统危险因素控制不佳的情况下,观察到的女性较低的HF风险显著减弱,甚至消失(性别危险因素P<0.05).选定的11个危险因素共同解释了62.5%(95%CI,55.1-68.8)的女性HF人群归因比例,远高于男性(人口归因分数，39.6%[95%CI，28.5-48.9]）。
结论：虽然在本研究中女性因心力衰竭住院的发生率低于男性，在几种传统危险因素控制不佳的情况下,女性的HF风险比男性增加更显著.这项研究表明，中国立即需要加强预防策略。
结果：数据来自中国PEACE（以患者为中心的心脏事件评估）百万人项目的一个子队列。在基线时收集传统的危险因素，研究结果为住院患者登记处确定的HF相关住院。共有102278名参与者(平均年龄，54.3年；39.5%的男性）没有普遍的HF被招募。在中位随访3.52年后，共捕获了1588例HF相关住院病例。男性的发病率（2.1％）明显高于女性（1.2％）。然而,在几个传统危险因素控制不佳的情况下,观察到的女性较低的HF风险显著减弱,甚至消失(性别危险因素P<0.05).选定的11个危险因素共同解释了62.5%(95%CI,55.1-68.8)的女性HF人群归因比例,远高于男性(人口归因分数，39.6%[95%CI，28.5-48.9]）。
结论：虽然在本研究中女性因心力衰竭住院的发生率低于男性，在几种传统危险因素控制不佳的情况下,女性的HF风险比男性增加更显著.这项研究表明，中国立即需要加强预防策略。
