MedWire News: The main risk factors for heart failure (HF) in the US population are hypertension in women and coronary artery disease (CAD) in men, study findings show.
The study, which was conducted between 1972 and 2002, also revealed some changing trends in HF risk factors, such as an increasing contribution of obesity. This “underscores the importance of continued surveillance of heart failure,” assert researchers Véronique Roger (Mayo Clinic, Rochester, Minnesota, USA) and colleagues.
The relative contribution of different risk factors to the development of HF remains controversial and has seldom been investigated in population-based studies.
“We aimed to address these gaps in knowledge and to evaluate the contribution of coronary disease, hypertension, diabetes mellitus, obesity, and smoking to heart failure,” Roger et al comment in the American Journal of Medicine.
They recruited 962 patients diagnosed with HF between 1972 and 2002 in Olmsted County, alongside 962 age- and gender-matched population controls.
Among female HF patients, hypertension was the most common risk factor, with a prevalence of 72.7%, followed by smoking (33.7%), and obesity (23.2%). Among male HF patients, a history of smoking was the most prevalent risk factor (71.6%), followed by hypertension (58.6%), and CAD (38.4%).
The mean number of HF risk factors per case was 1.9 and increased over time from 1.61 in 1979 to 2.13 in 2002.
CAD carried the greatest risk for the development of HF, with an odds ratio of 3.05, compared to 2.65 for diabetes and 2.00 for obesity.
The researchers then used these data to calculate the population attributable risk (PAR) for each factor.
In women, hypertension accounted for 28% of the PAR for HF, while CAD accounted for 16%. In men, CAD was responsible for the 23% of the PAR, and smoking for 22%.
The PAR for hypertension increased from 15% at the beginning of the study to 29% at the end, while obesity increased from 8% to 17%.
Discussing the findings Roger et al comment: “The present study has important public health implications and suggests that targeting prevention of hypertension and coronary disease might have the greatest impact on reducing the number of heart failure cases in the population.
“However, as the relative contribution of risk factors to the development of heart failure in the population continues to evolve, ongoing surveillance is important to maintain accurate preventive efforts.”
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