The Population Burden of Heart Failure Attributable to Modifiable Risk Factors

Avery, Christy L.; Loehr, Laura R.; Baggett, Christopher D.; Chang, Patricia; Kucharska‐Newton, Anna; Matsushita, Kunihiro; Rosamond, Wayne D.; Heiss, Gerardo

doi:10.1016/j.jacc.2012.07.022

Cited by 93 publications

(70 citation statements)

References 37 publications

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“…[39–45] Several common factors that predispose to HF in the population have been identified, most notably hypertension (present in 44–91% of cases at incident diagnosis)[10,22,40,43,46], diabetes (18–23%)[10,22,23,40,46], coronary artery disease (29–63%)[10,13,23,40,46], obesity (25%)[40], and a history of smoking (51%). [40] It should be recognized that multiple risk factors may co-exist and interact with each other in an individual patient.…”

Section: Epidemiology Of Heart Failurementioning

confidence: 99%

“…[41] Subsequently, the population impact that a modest reduction in the prevalence of modifiable risk factors in the population, including smoking, diabetes, hyperlipidemia, hypertension, and obesity were estimated. [39] They reported that a 5% decrement in the prevalence of diabetes in the U.S., for example, may prevent 30,000 incident HF cases annually. Thus, even small reductions in the prevalence of risk factors as a result of preventative health efforts may translate into large improvements in our ability to prevent the onset of HF in the population.…”

Section: Epidemiology Of Heart Failurementioning

confidence: 99%

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Understanding the Epidemic of Heart Failure: Past, Present, and Future

Dunlay

Roger

2014

Curr Heart Fail Rep

173

121

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Heart failure (HF) is a major public health problem affecting more than 5 million Americans and more than 23 million patients worldwide. The epidemiology of HF is evolving. Data suggests that the incidence of HF peaked in the mid 1990s and has since declined. Survival after HF diagnosis has improved, leading to an increase in prevalence. The case mix is also changing, as a rising proportion of patients with HF have preserved ejection fraction and multimorbidity is increasingly common. After diagnosis, HF can have a profound associated morbidity. Hospitalizations in HF remain both frequent and costly, though they may be declining as a result of preventive efforts. The need for skilled nursing facility care in HF has risen. The role of palliative medicine in the care of patients with advanced HF is evolving as we learn how to best care for this population with a large symptom burden.

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Section: Epidemiology Of Heart Failurementioning

confidence: 99%

Section: Epidemiology Of Heart Failurementioning

confidence: 99%

Understanding the Epidemic of Heart Failure: Past, Present, and Future

Dunlay

Roger

2014

Curr Heart Fail Rep

173

121

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“…10,11 Furthermore, prior studies have suggested that diabetes mellitus may be associated with an increased risk of heart failure. 12 However, it remains unclear whether this association is attributable to causal effects of diabetes mellitus or to other coexisting medical conditions (eg, hypertension, coronary artery disease, renal dysfunction). 13,14 Thus, we sought to use the Reduction of Atherothrombosis for Continued Health (REACH) registry to describe current long-term cardiovascular outcomes, including hospitalization for heart failure, and to identify predictors of these cardiovascular events in an international cohort of patients with diabetes mellitus.…”

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confidence: 99%

Impact of Diabetes Mellitus on Hospitalization for Heart Failure, Cardiovascular Events, and Death

et al. 2015

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Background-Despite the known association of diabetes mellitus with cardiovascular events, there are few contemporary data on the long-term outcomes from international cohorts of patients with diabetes mellitus. We sought to describe cardiovascular outcomes at 4 years and to identify predictors of these events in patients with diabetes mellitus. Methods and Results-The Reduction of Atherothrombosis for Continued Health (REACH) registry is an international registry of patients at high risk of atherothrombosis or established atherothrombosis. Four-year event rates in patients with diabetes mellitus were determined with the corrected group prognosis method. Of the 45 227 patients in the REACH registry who had follow-up at 4 years, 43.6% (n=19 699) had diabetes mellitus at baseline. The overall risk and hazard ratio (HR) of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke were greater in patients with diabetes compared with patients without diabetes (16.5% versus 13.1%; adjusted HR, 1.27; 95% confidence interval [CI] 1.19-1.35). There was also an increase in both cardiovascular death (8.9% versus 6.0%; adjusted HR, 1.38; 95% CI, 1.26-1.52) and overall death (14.3% versus 9.9%; adjusted HR, 1.40; 95% CI, 1.30-1.51). Diabetes mellitus was associated with a 33% greater risk of hospitalization for heart failure (9.4% versus 5.9%; adjusted odds ratio, 1.33; 95% CI, 1.18-1.50). In patients with diabetes mellitus, heart failure at baseline was independently associated with cardiovascular death (adjusted HR, 2.45; 95% CI, 2.17-2.77; P<0.001) and hospitalization for heart failure (adjusted odds ratio, 4.72; 95% CI, 4.22-5.29; P<0.001). Conclusions-Diabetes mellitus substantially increases the risk of death, ischemic events, and heart failure. Patients with both diabetes mellitus and heart failure are at particularly elevated risk of cardiovascular death, highlighting the need for additional therapies in this high-risk population. across the world. As a result, the international prevalence of diabetes mellitus is expected to continue to rise as risk factors for diabetes mellitus become more common. 7,8 Despite the high prevalence and clear association of diabetes mellitus with adverse events, there are few contemporary data on the long-term outcomes from an international cohort of patients with diabetes mellitus. Prior studies have suggested that diabetes mellitus is associated with an increase in risk that is of a magnitude similar to that of the presence of known atherothrombosis.9 Uncertainty about the current longterm outcomes of stable patients with diabetes mellitus has led to significant debate over whether diabetes mellitus is truly a risk equivalent to coronary artery disease in this population.10,11 Furthermore, prior studies have suggested that diabetes mellitus may be associated with an increased risk of heart failure.12 However, it remains unclear whether this association is attributable to causal effects of diabetes mellitus or to other coexisting medical conditions (eg, hypertension, coro...

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“…4 The Atherosclerosis Risk in Communities (ARIC) Study documented that the number of ideal Simple 7 factors achieved is associated strongly and inversely with later incidence of total cardiovascular disease, 5 heart failure, 6,7 and cancer. 8 Yet, no publication, to our knowledge, has specifically addressed the degree to which following Life’s Simple 7 might lower lifetime heart failure risk or preserve cardiac structure and function to old age.…”

mentioning

confidence: 99%

American Heart Association's Life's Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function

Folsom

Shah

Lutsey

et al. 2015

The American Journal of Medicine

Self Cite

165

111

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BACKGROUND Many people may underappreciate the role of lifestyle in avoiding heart failure. We estimated whether greater adherence in middle age to American Heart Association’s Life’s Simple 7 guidelines -- on smoking, body mass, physical activity, diet, cholesterol, blood pressure, and glucose -- is associated with lower lifetime risk of heart failure and greater preservation of cardiac structure and function in old age. METHODS We studied the population-based Atherosclerosis Risk in Communities Study cohort of 13,462 adults aged 45-64 years in 1987-89. From the 1987-89 risk factor measurements, we created a Life’s Simple 7 score (range 0-14, giving 2 points for ideal, 1 point for intermediate, and 0 points for poor components). We identified 2,218 incident heart failure events using surveillance of hospital discharge and death codes through 2011. In addition, in 4,855 participants free of clinical cardiovascular disease in 2011-13, we performed echocardiography from which we quantified left ventricular hypertrophy and diastolic dysfunction. RESULTS One in four participants (25.5%) developed heart failure through age 85. Yet, this lifetime heart failure risk was 14.4% for those with a middle-age Life’s Simple 7 score of 10-14 (optimal), 26.8% for a score of 5-9 (average), and 48.6% for a score of 0-4 (inadequate). Among those with no clinical cardiovascular event, the prevalence of left ventricular hypertrophy in late life was approximately 40% as common, and diastolic dysfunction was approximately 60% as common, among those with an optimal middle-age Life’s Simple 7 score compared with an inadequate score. CONCLUSIONS Greater achievement of American Heart Association’s Life’s Simple 7 in middle-age is associated with a lower lifetime occurrence of heart failure and greater preservation of cardiac structure and function.

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The Population Burden of Heart Failure Attributable to Modifiable Risk Factors

Cited by 93 publications

References 37 publications

Understanding the Epidemic of Heart Failure: Past, Present, and Future

Understanding the Epidemic of Heart Failure: Past, Present, and Future

Impact of Diabetes Mellitus on Hospitalization for Heart Failure, Cardiovascular Events, and Death

American Heart Association's Life's Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function

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