Risk factors for heart failure: A systematic review of prevalence and co-occurrence
Key Takeaways
In a population-based study, investigators found that multiple risk factors are often present in patients that develop heart failure (HF).
The most common risk factors for which RCT based interventions exist were hypertension, stable angina, unstable angina, myocardial infarction, and diabetes.
Additional studies that tackle co-occurring risk factors for HF simultaneously are needed to ensure the development of effective primary prevention strategies.
Prophylactic approaches aimed at preventing heart failure are often ineffective, potentially due to the presence of a wide range of risk factors.
Why This Study Matters
Studies that systematically evaluate the prevalence and potential for prevention across the range of underlying risk factors are limited. To address this need, this study estimated prevalence as well as the co-occurence of 92 recognized risk factors for heart failure identified from US and European clinical practice guidelines.
Study Design
Researchers reviewed observational evidence and trials aimed at HF prevention across the 92 selected risk factors, identifying 170,885 individuals over the age of 30 with incident HF from 1997-2017. Investigators accessed linked primary and secondary EHRs as well as rule-based phenotypes for each of the risk factors.
Results and Conclusions
Investigators were able to map 91 out of 92 risk factors to EHRs and 88 out of 91 of these factors were represented by at least one patient.
While only 10 out of 92 risk factors were found to have high quality evidence linking them with the incidence of HF, effective randomized controlled trial (RCT) based interventions for HF prevention were found for only 7 out of 92 risk factors. The most common risk factors for which RCT based interventions exist were hypertension, stable angina, unstable angina, myocardial infarction, and diabetes.
In the five years before being diagnosed with HF, 44.3% of subjects had at least 4 risk factors, indicating a significant burden of co-occurrence of risk factors.
For patients newly diagnosed with HF, 15.6% did not have any risk factors or only had risk factors that did not have any trials aimed at prevention.
Related Research
To learn more, consider these findings from similar research studies:
Disparities between racial, gender, and socioeconomic groups exist in terms of risk for developing heart failure (Source).
Substantial modifiable risk factors, such obesity and smoking, are associated with the incidence of HF (Source).
Original Source
Banerjee A, Pasea L, Chung S, et al. A population‐based study of 92 clinically recognised risk factors for heart failure: co‐occurrence, prognosis and preventive potential. European J of Heart Fail. Published online December 30, 2021:ejhf.2417.