Younger persons with chronic conditions at higher risk of heart failure

The prevalence of several chronic conditions is higher in patients with heart failure (HF) than population controls, suggests a recent study. Such associations are also seen in those with reduced and preserved ejection fraction, except for hypertension, which is more strongly associated with HF with preserved ejection fraction.

In addition, some cardiometabolic risk factors demonstrate a more robust association with HF in younger individuals, which highlights the importance of optimizing prevention and treatment of risk factors, particularly cardiometabolic risk factors.

In this study, the authors estimated the prevalence of 17 chronic conditions in 2,643 patients with incident HF from 2000 to 2013 and in controls matched 1:1 on sex and age from Olmsted County, Minnesota, in the US. Associations of each condition with HF were determined using logistic regression.

A total of 2,643 matched pairs (mean age, 76.2 years; 45.6 percent men) were included. The comorbidities with the largest attributable risk of HF were arrhythmia (48.7 percent), followed by coronary artery disease (CAD; 33.9 percent) and hypertension (28.4 percent); collectively, these conditions explained 73.0 percent of HF.

Similar associations were found for patients with reduced and preserved ejection fraction, except for hypertension. HF risk attributable to hypertension was twofold higher in HF patients with preserved ejection fraction (38.7 percent) than in those with reduced ejection fraction (17.8 percent).

Of note, the association of HF with hypertension, CAD, arrhythmia, and diabetes were more evident in younger (≤75 years) than in older (>75 years) persons.