{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:05Z","timestamp":1787018045215,"version":"build-2736575974"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cardiovascular disease disproportionately affects persons living in low- and middle-income countries and heart failure (HF) is thought to be a leading cause. Population-based studies characterizing the epidemiology of HF in these settings are lacking. We describe the age-standardized prevalence, survival, subtypes, risk factors, and 1-year mortality of HF in the population-based Haiti Cardiovascular Disease Cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Participants were recruited using multistage cluster-area random sampling in Port-au-Prince, Haiti. A total of 2981 completed standardized history and exam, laboratory measures, and cardiac imaging. Clinical HF was defined by Framingham criteria. Kaplan-Meier and Cox proportional hazard regression assessed mortality among participants with and without HF; logistic regression identified associated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among all participants, the median age was 40 years (interquartile range, 27\u201355), and 58.2% were female. Median follow-up was 15.4 months (interquartile range, 9\u201322). The age-standardized HF prevalence was 3.2% (93\/2981 [95% CI, 2.6\u20133.9]). The average age of participants with HF was 57 years (interquartile range, 45\u201365), and 67.7% were female. The first significant increase in HF prevalence occurred between 30 to 39 and 40 to 49 years (1.1% versus 3.7%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.003). HF with preserved ejection fraction was the most common HF subtype (71.0%). Age (adjusted odds ratio, 1.36 [1.12\u20131.66] per 10-year increase), hypertension (2.14 [1.26\u20133.66]), obesity (3.35 [95% CI, 1.99\u20135.62]), poverty (2.10 [1.18\u20133.72]), and renal dysfunction (5.42 [2.94\u20139.98]) were associated with HF. One-year HF mortality was 6.6% versus 0.8% (hazard ratio, 7.7 [95% CI, 2.9\u201320.6];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The age-standardized prevalence of HF in this low-income setting was alarmingly high at 3.2%\u20145-fold higher than modeling estimates for low- and middle-income countries. Adults with HF were two decades younger and 7.7\u00d7 more likely to die at 1 year compared with those in the community without HF. Further research characterizing the population burden of HF in low- and middle-income countries can guide resource allocation and development of pragmatic HF prevention and treatment interventions, ultimately reducing global cardiovascular disease health disparities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT03892265.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circoutcomes.122.009093","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T06:23:12Z","timestamp":1670307792000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Population-Based Epidemiology of Heart Failure in a Low-Income Country: The Haiti Cardiovascular Disease Cohort"],"prefix":"10.1161","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct03892265","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6788-1231","authenticated-orcid":true,"given":"Justin R.","family":"Kingery","sequence":"first","affiliation":[{"name":"Weill Cornell Medicine, New York, NY (J.R.K., N.L.R., R.P., M.S., D.F., J.W.P., M. McNairy)."},{"name":"Center for Global Health (J.R.K., N.L.R., V.R., L.Y., M.H.L., M. Metz, R.P., D.F., J.W.P., M. McNairy), Weill Medical College of Cornell University, New York, NY."},{"name":"University of Louisville School of Medicine, KY (J.R.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7238-8559","authenticated-orcid":true,"given":"Nicholas L.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine, New York, NY (J.R.K., N.L.R., R.P., M.S., D.F., J.W.P., M. McNairy)."},{"name":"Center for Global Health (J.R.K., N.L.R., V.R., L.Y., M.H.L., M. Metz, R.P., D.F., J.W.P., M. McNairy), Weill Medical College of Cornell University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Lookens Pierre","sequence":"additional","affiliation":[{"name":"Haitian Group for the Study of Kaposi\u2019s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti (J.L.P., R.S., E.D., V.R., M.M.D., J.W.P., M. McNairy)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Sufra","sequence":"additional","affiliation":[{"name":"Haitian Group for the Study of Kaposi\u2019s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti (J.L.P., R.S., E.D., V.R., M.M.D., J.W.P., M. McNairy)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliezer","family":"Dade","sequence":"additional","affiliation":[{"name":"Haitian Group for the Study of Kaposi\u2019s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti (J.L.P., R.S., E.D., V.R., M.M.D., J.W.P., M. McNairy)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Rouzier","sequence":"additional","affiliation":[{"name":"Center for Global Health (J.R.K., N.L.R., V.R., L.Y., M.H.L., M. Metz, R.P., D.F., J.W.P., M. McNairy), Weill Medical College of Cornell University, New York, NY."},{"name":"Haitian Group for the Study of Kaposi\u2019s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti (J.L.P., R.S., E.D., V.R., M.M.D., J.W.P., M. 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