High Lifetime HF Risks Point to Greater Need for Preventive Efforts

A study published on April 1 in the Journal of the American College of Cardiology compared the lifetime risks of developing heart failure (HF) among men and women and blacks and whites, and found that the very high rates of lifetime HF risks underscore the importance of population-wide preventive efforts to curb the growing burden of HF in the U.S.

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The study was conducted by the Cardiovascular Lifetime Risk Pooling Project, and looked at 39,587 participants (85 percent white and 15 percent black) in three cohorts, of which, 5,983 developed HF. Results showed that at age 45, lifetime risks for HF through age 95 in the Chicago Heart Association Detection Project in Industry and Cardiovascular Health Study cohorts were 30 percent to 42 percent in white men, 20 percent to 29 percent in black men, 32 percent to 39 percent in white women, and 24 percent to 46 percent in black women. Results for the Atherosclerosis Risk in Communities cohort demonstrated similar lifetime risks for HF in blacks and whites through age 75 years.

In addition, a lower BMI (<25 kg/m2) was associated with a lower adjusted cumulative risk for HF in all gender-race groups through age 75 compared with a BMI of 25 kg/m2 or above. Further, participants with optimal BP (≤120/≤80 mm Hg) had lower lifetime risks for HF through age 75 compared with participants who had stage II hypertension (160/100 mm Hg) or greater, or those who had been treated for hypertension.

The researchers also performed gender-specific and race-specific estimates of lifetime HF risks according to whether participants had an antecedent myocardial infarction (MI). The lifetime risks were lower in participants who had not had a prior MI in almost all gender-race groups.

"If risk factors for HF are not treated more aggressively in both whites and blacks, HF incidence and costs will likely increase further, particularly as the U.S. population ages," the authors note. They conclude that the data "should help clinicians, researchers, and policymakers to more clearly understand how great of a problem HF currently is and will continue to be unless preventive measures are broadly implemented."

Keywords: Incidence, Myocardial Infarction, Atherosclerosis, Body Mass Index, European Continental Ancestry Group, Heart Failure, Risk Factors, African Continental Ancestry Group, Hypertension, United States

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