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Prevalence and temporal trends of anemia in patients with heart failure.

BACKGROUND
Anemia is an important comorbidity in heart failure (HF), and it is associated with increased adverse disease experience and mortality. Previous reports have focused mainly on HF presenting in healthcare settings. We therefore set out to establish the nationwide prevalence and temporal trends of anemia in community-based patients with HF in the US.


METHODS
We utilized the National Health and Nutrition Examination data collected over five survey cycles (2007-2016). Included were participants aged 20-80 years with self-reported diagnosis of HF. Anemia was defined using two sex specific cut offs of 13g/dl and 12g/dl (cutoff 1), and 12g/dl and 11g/dl (cutoff 2), for men and women, respectively. The Chi square test was used to compare prevalence across different categories and survey cycles. Data analysis was done using STATA 16 with p-values<0.05 considered statistically significant.


RESULTS
The median hemoglobin in all HF patients was 13.5g/dl (IQR 12.4-14.5). The prevalence of anemia among community-based patients with HF in the US was 21.34% (cutoff 1) and 9.03% (cutoff 2) and has been stable from 2007-2016. The burden of anemia was disproportionately higher in NH Blacks (34.48%, 95% CI 27.12-42.67) and those with BMI < 25Kg/m2 (17.4%, 95% CI 10.9-26.64).


CONCLUSION
The prevalence of anemia in patients with HF in the US is at least 9% and has remained stable over the past decade. This high persistent burden with limited proven interventions should spur further efforts aimed at identifying impactful ways of addressing anemia in patients with HF.