Comparison of incidence rates and risk factors of heart failure between two male cohorts born 30 years apart

Abstract

ObjectiveTo compare two cohorts of middle-aged men from the general population born 30 years apart for incidence and predictors of heart failure (HF).MethodsTwo population samples of men, born in 1913 (n=855) and in 1943 (n=797), were examined at 50 years of age and followed up for 21 years (1963–1994 and 1993–2014). Cox regression analysis was used to examine the impact of different factors on the risk of developing HF.ResultsEighty men born in 1913 (9.4%) and 42 men born in 1943 (5.3%) developed HF during follow-up; adjusted HRs comparing the two cohorts (born 1943 vs 1913) were: 0.46 (95% CI 0.28 to 0.74, p=0.002). In both cohorts, higher body mass index, higher diastolic blood pressure, treatment for hypertension, onset of either atrial fibrillation (AF), ischaemic heart disease and diabetes mellitus were associated with higher risk of HF. Higher heart rate was associated with an increased risk only in men born in 1913, whereas higher systolic blood pressure (SBP), smoking, higher glucose, higher cholesterol and physical inactivity were associated with an increased risk in men born in 1943. AF contributed higher risk of incident HF, whereas SBP and physical inactivity contributed lower risk in men born in 1943 compared with men born in 1913.ConclusionsMen born in 1943 had half the risk of HF after their 50s than those born 30 years earlier. AF, obesity, ischaemic heart disease, diabetes and hypertension remain important precursors of HF.

Body Composition and Risk of Incident Heart Failure in 1 Million Adults: A Systematic Review and Dose–Response Meta‐Analysis of Prospective Cohort Studies

“…The review included 35 prospective studies involving 1 137 044 individuals at baseline and 34 422 incident HF cases. There were 20 studies conducted in Europe, 19 , 24 , 25 , 26 , 29 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 13 in the United States, 3 , 5 , 20 , 21 , 22 , 23 , 27 , 28 , 30 , 61 , 62 , 63 , 64 , 65 , 66 , 67 and 2 in Australia. 11 , 68 Many of the studies recruited mainly White populations (n=19), 15 studies were multiracial, whereas only the Jackson Heart Study 30 in the United States recruited only Black participants.…”

“…Thirty‐two cohorts were included in the dose–response meta‐analysis of the association of BMI and incident HF (Figure 2 ). 5 , 11 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 48 , 49 , 50 , 51 , 53 , 54 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 67 , 68 , 72 There were 28 396 HF incident events among 1 095 412 participants. The summary RR of HF for each 5‐kg/m 2 higher BMI was 1.42 (95% CI, 1.40–1.44).…”

“…Several prospective studies have been published since the last systematic review in this area, and there is a need for an updated systematic review including all the current evidence. 3 , 11 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 Also, to the best of our knowledge, no meta‐analyses have yet determined the associations between any of the measures of body composition and risk of HF subtypes. This is, in part, because such studies require measures of cardiac function that have not been feasible to include in large‐scale studies until recently.…”