Exploration of Cardiology

Table 3. Association between allostatic load (AL) and mortality outcomes among individuals with heart failure in the NHANES cohort.

AL	N/Case	HR	95% CI	P value
*CVD-death*
Model 1
AL score = low		Reference
AL score = medium	269/68	1.11	0.83–1.49	0.494
AL score = high	428/127	1.31	1.03–1.68	0.030
P for trend	1,200/324	1.15	1.01–1.30	0.031
Per unit increment	1,200/324	1.08	1.01–1.15	0.024
Model 2
AL score = low		Reference
AL score = medium	233/57	1.15	0.83–1.59	0.399
AL score = high	371/113	1.58	1.21–2.06	0.001
P for trend	1,040/288	1.26	1.10–1.44	0.001
Per unit increment	1,040/288	1.14	1.06–1.23	0.001
Model 3
AL score = low		Reference
AL score = medium	63/16	1.30	0.82–2.07	0.261
AL score = high	101/29	2.03	1.37–3.03	< 0.001
P for trend	586/144	1.42	1.16–1.74	0.001
Per unit increment	586/144	1.18	1.05–1.33	0.007
*All cause-death*
Model 1
AL score = low		Reference
AL score = medium	269/174	1.21	1.00–1.45	0.048
AL score = high	428/291	1.26	1.07–1.48	0.005
P for trend	1,200/773	1.12	1.04–1.22	0.004
Per unit increment	1,200/773	1.07	1.03–1.12	0.002
Model 2
AL score = low		Reference
AL score = medium	233/148	1.33	1.08–1.63	0.007
AL score = high	371/253	1.54	1.29–1.84	< 0.001
P for trend	1,040/671	1.24	1.14–1.35	< 0.001
Per unit increment	1,040/671	1.14	1.08–1.19	< 0.001
Model 3
AL score = low		Reference
AL score = medium	111/77	1.35	1.01–1.79	0.041
AL score = high	163/120	1.70	1.30–2.22	< 0.001
P for trend	586/353	1.31	1.15–1.49	< 0.001
Per unit increment	586/353	1.15	1.06–1.24	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. NHANES: National Health and Nutrition Examination Survey; HR: hazard ratio; CI: confidence interval; CVD: cardiovascular disease.

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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