Exploration of Cardiology

Table 2. Association between AL and incident heart failure in the HRS cohort.

AL	N/Case (%)	OR	95% CI	P value
Model 1
Low AL (0–2)		Reference
Medium AL (3)	1,059/29 (2.7)	1.44	0.94–2.21	0.090
High AL (≥ 4)	1,002/103 (10.28)	2.17	1.46–3.21	< 0.001
P for trend	3,814/151 (4.0)	1.47	1.21–1.79	< 0.001
Per unit increment	3,814/151 (4.0)	1.49	1.21–1.82	< 0.001
Model 2
Low AL (0–2)		Reference
Medium AL (3)	1,058/29 (2.7)	1.50	0.98–2.32	0.064
High AL (≥ 4)	999/103 (10.3)	2.21	1.47–3.33	< 0.001
P for trend	3,807/151 (4.0)	1.49	1.21–1.82	< 0.001
Per unit increment	3,807/151 (4.0)	1.45	1.28–1.61	< 0.001
Model 3
Low AL (0–2)		Reference
Medium AL (3)	842/22 (2.6)	1.26	0.75–2.11	0.391
High AL (≥ 4)	823/81 (9.8)	2.07	1.29–3.32	0.002
P for trend	2,951/115 (3.90)	1.46	1.14–1.84	0.002
Per unit increment	2,951/115 (3.90)	1.30	1.13–1.49	< 0.001

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Model 1 was unadjusted; Model 2 adjusted for age, sex, education level, marital status, race/ethnicity, and income; Model 3 further adjusted for smoking, drinking, serum creatinine, coronary heart disease, antihypertensive medication, and diabetes. HRS: Health and Retirement Study; AL: allostatic load; OR: odds ratio; CI: confidence interval.

Supplementary materials

The supplementary materials for this article are available at: https://www.explorationpub.com/uploads/Article/file/1012118_sup_1.pdf.

Declarations

Acknowledgments

While preparing this work, the authors used OpenAI and DeepSeek to enhance clarity and readability. After using the tools, the authors reviewed and edited the content as needed and take full responsibility for the publication’s content.

Author contributions

GH: Conceptualization, Supervision, Writing—review & editing. YN: Data curation, Formal analysis, Methodology, Visualization, Writing—original draft. H Zhang, FH, LS, XQ, HX, H Zhu, YD, and HC: Investigation, Validation, Writing—review & editing. All authors contributed to the article and approved the final submitted version.

Conflicts of interest

The authors have nothing to declare.

Ethical approval

The NHANES protocol was approved by the National Center for Health Statistics Research Ethics Review Board (Protocol #98-12, #2005-06, and #2011-17), and the HRS study was approved by the University of Michigan Health Sciences and Behavioral Sciences Institutional Review Board (HUM00061128). Both studies comply with the Declaration of Helsinki, and all participants provided written informed consent.

Consent to participate

Informed consent was obtained from all participants in the original studies.

Consent to publication

Not applicable.

Availability of data and materials

The NHANES and HRS datasets analyzed during the current study are publicly available from the official websites of the National Center for Health Statistics and the Health and Retirement Study program.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Copyright

Publisher’s note

Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.

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