Cited by 2,155Heart Failure Treatment and ManagementBlood Pressure and Hypertension StudiesCardiovascular Function and Risk Factors

The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index.

The Progression From Hypertension to Congestive Heart Failure

Levy, Daniel·1996·JAMA: The Journal of the American Medical Association

DOI 10.1001/jama.1996.03530440037034

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Abstract

OBJECTIVES: - To study the relative and population-attributable risks of hypertension for the development of congestive heart failure (CHF), to assess the time course of progression from hypertension to CHF, and to identify risk factors that contribute to the development of overt heart failure in hypertensive subjects. DESIGN: - Inception cohort study. SETTING: - General community. PARTICIPANTS: - Original Framingham Heart Study and Framingham Offspring Study participants aged 40 to 89 years and free of CHF. To reflect more contemporary experience, the starting point of this study was January 1, 1970. EXPOSURE MEASURES: - Hypertension (blood pressure of at least 140 mm Hg systolic or 90 mm Hg diastolic or current use of medications for treatment of high blood pressure) and other potential CHF risk factors were assessed at periodic clinic examinations. OUTCOME MEASURE: - The development of CHF. RESULTS: - A total of 5143 eligible subjects contributed 72422 person-years of observation. During up to 20.1 years of follow-up (mean, 14.1 years), there were 392 new cases of heart failure; in 91% (357/392), hypertension antedated the development of heart failure. Adjusting for age and heart failure risk factors in proportional hazards regression models, the hazard for developing heart failure in hypertensive compared with normotensive subjects was about 2-fold in men and 3-fold in women. Multivariable analyses revealed that hypertension had a high population-attributable risk for CHF, accounting for 39% of cases in men and 59% in women. Among hypertensive subjects, myocardial infarction, diabetes, left ventricular hypertrophy, and valvular heart disease were predictive of increased risk for CHF in both sexes. Survival following the onset of hypertensive CHF was bleak; only 24% of men and 31% of women survived 5 years. CONCLUSIONS: - Hypertension was the most common risk factor for CHF, and it contributed a large proportion of heart failure cases in this population-based sample. Preventive strategies directed toward earlier and more aggressive blood pressure control are likely to offer the greatest promise for reducing the incidence of CHF and its associated mortality.

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BackgroundResultInfluential
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MethodResult
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Background
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Background
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Background
The role of estrogen in the sex difference for the risk factors of heart failure with preserved ejection fraction
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A single resistance exercise session improves myocardial contractility in spontaneously hypertensive rats
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“Arterial hypertension (AH) is associated with a higher risk of cardiac abnormalities due to hypertrophy of myocardial cells and capillaries, and of interstitium abnormalities that lead to alterations in myocardial structural and molecular mechanisms, resulting in development of cardiomyopathy and heart failure (1).”
Background
Systolic Blood Pressure and Mortality in Patients with Atrial Fibrillation and Heart Failure: Insights from the AFFIRM and AF-CHF Studies
Tremblay‐Gravel, M., Khairy, P., Roy, D., Leduc, H., Wyse, D. G., Cadrin‐Tourigny, J., Macle, L., Dubuc, M., Andrade, J. G., Rivard, L., et al. (2014) · European Journal of Heart Failure · doi:10.1002/ejhf.168 · Cited by 18
Dabigatran vs. warfarin in relation to the presence of left ventricular hypertrophy in patients with atrial fibrillation— the Randomized Evaluation of Long-term anticoagulation therapY (RE-LY) study
Verdecchia, P., Reboldi, G., Angeli, F., Mazzotta, G., Lip, G. Y. H., Brueckmann, M., Kleine, E., Wallentin, L. C., Ezekowitz, M. D., Yusuf, S., et al. (2017) · EP Europace · doi:10.1093/europace/eux022 · Cited by 17
“LVH may be associated with overt or subclinical heart failure.(25) The decrease in oxygen delivery to the liver, potentially associated with episodes of heart failure, might impair the hepatic clearance of warfarin via cytochrome P450, known to require a considerable amount of oxygen to perform oxidative reactions.”
Background
Associations of awake and asleep blood pressure and blood pressure dipping with abnormalities of cardiac structure
Bello, N. A., Jaeger, B. C., Booth, J. N., Abdalla, M., Anstey, D. E., Pugliese, D. N., Lewis, C. E., Gidding, S. S., Lloyd‐Jones, D. M., Shah, S. J., et al. (2019) · Journal of Hypertension · doi:10.1097/hjh.0000000000002221 · Cited by 17
The Diabetic Cardiorenal Nexus
D’Elia, J. A., Bayliss, G. P., & Weinrauch, L. A. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23137351 · Cited by 17
“Cardiomyopathy has been described in type 1 diabetes (DM1) [5–8], hypertension [9,10], and obesity [11,12] each of which may ultimately have a renal role in uremia-specific cardiomyopathy [13,14] (Table 1) through cardiorenal linkages involving the interdependence of myocardial relaxation/contraction and tubuloglomeru…”
Background
Myostatin and insulin-like growth factor-1 in hypertensive heart disease
Fernández‐Solà, J., Borrisser-Pairó, F., Antúnez, E., & Tobías, E. (2015) · Journal of Hypertension · doi:10.1097/hjh.0000000000000493 · Cited by 17
“In fact, arterial hypertension (AHT) is the most important risk factor for heart failure [3].”
Impact of Blood Pressure Control on Prevalence of Left Ventricular Hypertrophy in Treated Hypertensive Patients
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“The main alterations that in cardiac hypertrophy may contribute to the increased incidence of cardiovascular complications include an impairment of diastolic function at rest and of systolic performance during exercise, a reduced coronary reserve and increased ventricular arrythmias [ ,”
Background
Immigrant status and increased risk of heart failure: the role of hypertension and life-style risk factors
Borné, Y., Engström, G., Essén, B., & Hedblad, B. (2012) · BMC Cardiovascular Disorders · doi:10.1186/1471-2261-12-20 · Cited by 17
“, age, sex, smoking, hypertension, diabetes, abdominal obesity, alcohol consumption and physical activity are well known cardiovascular risk factors [2,4,5,9,10,12,42,43].”
Effects of Zolpidem CR on Sleep and Nocturnal Ventilation in Patients with Heart Failure
Gatti, R. C., Burke, P. R., Otuyama, L. J., Almeida, D. R., Tufik, S. B., & Poyares, D. R. (2016) · SLEEP · doi:10.5665/sleep.6006 · Cited by 19
Ischemic heart disease in women and the role of hormone therapy
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Gender differences in variables related to B-natriuretic peptide, left ventricular ejection fraction and mass, and peak oxygen consumption, in patients with heart failure
Tasevska-Dinevska, G., Kennedy, L. M. A., Cline-Iwarson, A., Cline, C. M. J., Erhardt, L., & Willenheimer, R. B. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2010.02.018 · Cited by 17
REPRINT Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease
Rosendorff, C., Black, H. R., Cannon, C. P., Gersh, B. J., Gore, J. M., Izzo, J. L., Kaplan, N. M., O’Connor, C. M., O’Gara, P. T., & Oparil, S. (2007) · Hypertension · doi:10.1161/hypertensionaha.107.183885 · Cited by 18
The COHERE registry: Hype or hope?
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The long-term outcome of patients with hypertensive cardiomyopathy
Frimm, C. D. C., Soufen, H. N., Koike, M. K., Pereira, V. F. A., & Cúri, M. (2005) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1001836 · Cited by 17
ACLY Promotes Cardiac Fibrosis via the Regulation of DNL and Histone Acetylation
Kuwahara, N., Nagao, M., Shinohara, M., Kaneshiro, K., Emoto, T., Yoshida, T., Fukuda, T., Nishimori, M., Satomi‐Kobayashi, S., Otake, H., et al. (2025) · Hypertension · doi:10.1161/hypertensionaha.124.24088 · Cited by 18
“4,5 During cardiac fibrosis progression in HF, fibroblasts become activated and differentiate into myo-fibroblasts, leading to the increased production of collagen fibers.”
Association between long-term exposure to Sulfur dioxide pollution and hypertension incidence in northern China: a 12-year cohort study
Yan, M., Li, C., Zhang, L., Chen, X., Yang, X., Shan, A., Li, X., Wu, H., Ma, Z., Zhang, Y., et al. (2020) · Environmental Science and Pollution Research · doi:10.1007/s11356-020-08572-z · Cited by 16
Association of neck circumference and hypertension among adults in a rural community Thailand: A cross-sectional study
Soitong, P., Jangjaicharoen, S., Kaewsanit, A., Mali, P., Viriyakhaikul, Y., Boonnumma, S., Tipmabutr, S., Chalermchuang, P., Maneechot, W., Numnoi, C., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0256260 · Cited by 16
“High blood pressure is associated with atherosclerotic cardiovascular diseases (ASCVD) including stroke, ischemic heart disease, and peripheral vascular disease [2, 3].”
Background
Concomitantly higher resting arterial blood pressure and transduction of sympathetic neural activity in human obesity without hypertension
Holwerda, S. W., Gangwish, M. E., Luehrs, R. E., Nuckols, V. R., Thyfault, J. P., Miles, J. M., & Pierce, G. L. (2022) · Journal of Hypertension · doi:10.1097/hjh.0000000000003335 · Cited by 17
The link between immunity and hypertension in the kidney and heart
Benson, L. N., Guo, Y., Deck, K. S., Mora, C. J., Liu, Y., & Mu, S. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1129384 · Cited by 17
The Sympathetic Nervous System in Hypertensive Heart Failure with Preserved LVEF
Triposkiadis, F. K., Briasoulis, Α., Sarafidis, P. A., Magouliotis, D. E., Athanasiou, T., PARASKEVAIDIS, I. A., Skoularigis, J. S., & Xanthopoulos, A. V. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12206486 · Cited by 18
“…[21] (Figure 1). synthe-sizes the catecholamines epinephrine (EPI) and norepinephrine (NEPI) at a ratio of 4:1, which also serve as SNS neurotransmitters of the SNS postganglionic fibers [21] (Figure ). and females two-and three-fold respectively [11], is tightly linked with SNS overactivity [12].”
Background
Burden of Cardio-Cerebrovascular and Renal Diseases Attributable to Systolic Hypertension in France in 2021
Grave, C., Bonaldi, C., Carcaillon‐Bentata, L., Gabet, A., Halimi, J., Tzourio, C., Béjot, Y., Torres, M. J., Steg, P. G., Durand‐Zaleski, I., et al. (2024) · Hypertension · doi:10.1161/hypertensionaha.124.23760 · Cited by 16
“Although the causal association of hypertension with cardiovascular diseases, stroke, and renal diseases is nowadays undisputed, 16,27,57,66 the association between dementia and hypertension is more complex to understand, meaning that this pathology is excluded from the majority of studies…”
Height and Risk of Heart Failure in the Physicians' Health Study
Akinkuolie, A. O., Aleardi, M., Ashaye, A. O., Gaziano, J. M., & Djoussé, L. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.11.032 · Cited by 16
Long-term cardiovascular risk of hypertensive events in emergency department: A population-based 10-year follow-up study
Lee, S., You, C.-Y., Kim, J., Jo, Y. H., Ro, Y. S., Kang, S., & Lee, H. (2018) · PLoS ONE · doi:10.1371/journal.pone.0191738 · Cited by 16
Improving risk stratification in heart failure with preserved ejection fraction by combining two validated risk scores
Boralkar, K. A., Kobayashi, Y., Moneghetti, K. J., Pargaonkar, V. S., Tuzovic, M., Krishnan, G., Wheeler, M. T., Banerjee, D., Kuznetsova, T., Horne, B. D., et al. (2019) · Open Heart · doi:10.1136/openhrt-2018-000961 · Cited by 16
Protective Effect of Vitis labrusca Leaves Extract on Cardiovascular Dysfunction through HMGB1-TLR4-NFκB Signaling in Spontaneously Hypertensive Rats
Kim, H. Y., Hong, M. H., Yoon, J. J., Kim, D. S., Na, S. W., Jang, Y. J., Lee, Y. J., Kang, D. G., & Lee, H. S. (2020) · Nutrients · doi:10.3390/nu12103096 · Cited by 16
“Furthermore, hypertension is attributed to structural and functional changes in the heart, such as LV hypertrophy, left atrial enlargement, and impairment of LV systolic and diastolic function [2].”
Background
Clinical Usefulness of the HFA-PEFF Diagnostic Scoring System in Identifying Late Elderly Heart Failure With Preserved Ejection Fraction Patients
Seo, Y., Ishizu, T., Ieda, M., Ohte, N., & for the J-LONG Study Investigators (2020) · Circulation Journal · doi:10.1253/circj.cj-20-0784 · Cited by 16
Certain beta blockers (e.g., bisoprolol) may be reevaluated in hypertension guidelines for patients with left ventricular hypertrophy to diminish the ventricular arrhythmic risk
Koracevic, G. P., Stojanović, M., Lović, D. B., Zdravkovic, M. D., & Sakač, D. (2021) · Journal of Human Hypertension · doi:10.1038/s41371-021-00505-8 · Cited by 16
“The majority of HF patients had HTN [85] (91% in the Framingham heart study) [89]; in this study, HTN was the main modifiable RF; in man the populationattributable risk was 39% and for women it was no less than 59% [90].”
Background
Therapeutic Stalemate in Heart Failure With Preserved Ejection Fraction
Samson, R., & Jemtel, T. H. L. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.121.021120 · Cited by 16
Drug‐related problems among hospitalized hypertensive and heart failure patients and physician acceptance of pharmacists' interventions at a teaching hospital in Ghana
Harrison, M. A., Marfo, A. F. A., Buabeng, K. O., Nkansah, F. A., Boateng, D. P., & Ankrah, D. (2022) · Health Science Reports · doi:10.1002/hsr2.786 · Cited by 16
Effect of reminder cards on compliance with antihypertensive medication
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Polymorphisms, Hypertension and Thiazide Diuretics
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Cytokines profile in hypertensive patients with left ventricular remodeling and dysfunction
Kuznetsova, T., Haddad, F., Knez, J., Rosenberg‐Hasson, Y., Sung, J., Cauwenberghs, N., Thijs, L., Karakikes, I., Maecker, H. T., Mahaffey, K. W., et al. (2015) · Journal of the American Society of Hypertension · doi:10.1016/j.jash.2015.10.003 · Cited by 18
Epidemiology of Hypertension
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Self-citation
Relation between the Updated Blood Pressure Classification according to the American College of Cardiology/American Heart Association Guidelines and Carotid Intima-Media Thickness
Itoh, H., Kaneko, H., Kiriyama, H., Yoshida, Y., Nakanishi, K., Mizuno, Y., Daimon, M., Morita, H., Yatomi, Y., & Komuro, I. (2019) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2019.04.054 · Cited by 16
Sex and Gender-Related Issues in Heart Failure
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Authors: Levy, D.
Affiliations: Framingham Heart Study (US)
Corresponding author: Levy, Daniel
ORCID: Levy, Daniel
Venue: JAMA: The Journal of the American Medical Association
Publisher: American Medical Association (AMA)
Published: 1996-05-22
Volume: 275
Issue: 20
Pages: 1557
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.1996.03530440037034
OpenAlex: W2023515446
Cited by: 2,155
References: 46
Citations by year: 2026: 32 · 2025: 62 · 2024: 62 · 2023: 85 · 2022: 82 · 2021: 73 · 2020: 71 · 2019: 86 · 2018: 70 · 2017: 75 · 2016: 68 · 2015: 98 · 2014: 86 · 2013: 102 · 2012: 108
FWCI: 27.57
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (n01hc038038-022)
National Heart, Lung, and Blood Institute (N01-HC-38038)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords: hypertension, congestive heart failure, population attributable risk, heart failure risk factors, myocardial infarction, diabetes mellitus, left ventricular hypertrophy, valvular heart disease, blood pressure control, Framingham Heart Study, Framingham Offspring Study
MeSH terms: Adult, Aged, Diastole, Female, Heart Failure, Humans, Hypertension, Longitudinal Studies, Male, Middle Aged, Risk Factors, Systole, Cohort Studies, Multivariate Analysis, Proportional Hazards Models, Survival Analysis, Hypertrophy, Left Ventricular, Disease Progression, Ventricular Dysfunction, Left

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The Progression From Hypertension to Congestive Heart Failure

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