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
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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“up to 91% of all new heart failure development in the Framingham cohort occurred in people with a previous diagnosis of hypertension (275).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [275]
In the citing paper
“The vast majority of incident heart failure is preceded by hypertension;”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [275]
In the citing paper
“The vast majority of incident heart failure is preceded by hypertension; up to 91% of all new heart failure development in the Framingham cohort occurred in people with a previous diagnosis of hypertension (272).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [272]
In the citing paper
“Using 50 years of follow up data, Levy and colleagues reported that the 5 year mortality declined in men from 70% in 1950 to 59% in 1999, and in women from 57% to 45%.58”
From The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective (2014) · cites this paper as [58]
In the citing paper
“Using 50 years of follow up data, Levy and colleagues reported that the 5 year mortality declined in men from 70% in 1950 to 59% in 1999, and in women from 57% to 45%.58”
From The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective (2014) · cites this paper as [58]
In the citing paper
“Over 50% of heart disease, stroke, and heart failure are caused by increased blood pressure.”
From São Paulo call to action for the prevention and control of high blood pressure: 2020 (2019) · cites this paper as [8]
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Cardiac Output as a Potential Risk Factor for Abnormal Brain Aging
Jefferson, A. L. (2010) · Journal of Alzheimer s Disease · doi:10.3233/jad-2010-100081 · Cited by 113
“Vascular risk factors can also result in myocardial damage, often without overt myocardial infarction, thereby altering cardiac function [7,8].”
Antecedent hypertension and heart failure after myocardial infarction
Richards, M., Nicholls, M. G., Troughton, R. W., Lainchbury, J. G., Elliott, J., FRAMPTON, C. M. A., Espiner, E. A., Crozier, I., Yandle, T. G., & Turner, J. G. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)01737-0 · Cited by 111
“This finding is consistent with evidence indicating that 90% of patients who eventually present with overt cardiac failure have an antecedent history of hypertension (27).”
ResultCongestive heart failure in Latin America: the next epidemic
Cubillos-Garzón, L. A., Casas, J. P., Morillo, C. A., & Bautista, L. E. (2004) · American Heart Journal · doi:10.1016/j.ahj.2003.07.026 · Cited by 107
Aging-induced biological changes and cardiovascular diseases.
Fajemiroye, J. O., Cunha, L. C. D., Saavedra-Rodríguez, R., Rodrigues, K. L., Naves, L. M., Mourão, A. A., Silva, E. F. D., Williams, N. E. E., Martins, J. L. R., Sousa, R. B., et al. (2018) · BioMed Research International · doi:10.1155/2018/7156435 · Cited by 109
“In fact, the LVH in hypertensive patients correlated to higher risk of developing systolic heart failure [187].”
BackgroundPlasma levels of matrix metalloproteinases and their inhibitors in hypertension
Marchesi, C., Dentali, F., Nicolini, E., Maresca, A. M., Tayebjee, M., Franz, M., Guasti, L., Venco, A., Schiffrin, E. L., Lip, G. Y. H., et al. (2011) · Journal of Hypertension · doi:10.1097/hjh.0b013e32834d249a · Cited by 109
Role of Irisin in Myocardial Infarction, Heart Failure, and Cardiac Hypertrophy
Ho, M.-Y., & Wang, C. (2021) · Cells · doi:10.3390/cells10082103 · Cited by 114
“High blood pressure causes pressure overload and myocardial hypertrophy, and a hypertrophic heart leads to heart failure [84].”
BackgroundPrimary prevention of essential hypertension
Krousel-Wood, M. A., Muntner, P., He, J., & Whelton, P. K. (2004) · Medical Clinics of North America · doi:10.1016/s0025-7125(03)00126-3 · Cited by 110
Devereux, R. B., Roman, M. J., Paranicas, M., Lee, E. T., Welty, T. K., Fabsitz, R. R., Robbins, D. C., Rhoades, E. R., Rodeheffer, R. J., Cowan, L. D., et al. (2001) · American Heart Journal · doi:10.1067/mhj.2001.113223 · Cited by 109
Gardin, J. M., & Lauer, M. S. (2004) · JAMA · doi:10.1001/jama.292.19.2396 · Cited by 109
Novel Metabolic Risk Factors for Heart Failure
Ingelsson, E., Ärnlöv, J., Sundström, J., Zethelius, B., Vessby, B. O., & Lind, L. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.07.059 · Cited by 108
Antecedent Blood Pressure, Body Mass Index, and the Risk of Incident Heart Failure in Later Life
Lee, D. S., Massaro, J. M., Wang, T. J., Kannel, W. B., Benjamin, E. J., Kenchaiah, S., Levy, D. A., D’Agostino, R. B., & Vasan, R. S. (2007) · Hypertension · doi:10.1161/hypertensionaha.107.095380 · Cited by 108
“13 The present investigation focused on systolic BP, diastolic BP, pulse pressure, and BMI because these variables: (1) are major risk factors for heart failure, (2) are modifiable with lifestyle or pharmacological interventions, (3) are easily measured, (4) were repeatedly measured at biennial Heart Study visits, and…”
BackgroundSelf-citationPoulsen, S. H., Andersen, N. H., Ivarsen, P., Mogensen, C.-E., & Egeblad, H. (2003) · Journal of the American Society of Echocardiography · doi:10.1016/s0894-7317(03)00403-6 · Cited by 108
10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s010 · Cited by 107
Liu, Y.-W., Tsai, W., Su, C.-T., Lin, C.-C., & Chen, J.-H. (2009) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2009.05.006 · Cited by 110
Okin, P. M., Devereux, R. B., Nieminen, M. S., Jern, S., Oikarinen, L., Viitasalo, M. T., Toivonen, L. K., Kjeldsen, S. E., & Dahlöf, B. (2005) · Circulation · doi:10.1161/circulationaha.105.569491 · Cited by 106
The 1999 WHO–ISH Guidelines for the Management of Hypertension
Chalmers, J. P. (1999) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1999.tb123747.x · Cited by 106
The Population Burden of Heart Failure Attributable to Modifiable Risk Factors
Avery, C. L., Loehr, L. R., Baggett, C. D., Chang, P. P., Kucharska‐Newton, A., Matsushita, K., Rosamond, W. D., & HEISS, G. M. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.07.022 · Cited by 106
“Although population-attributable risk estimates are more commonly reported in studies examining the population burden of heart failure (12,36), we chose to present PIFs, as these estimates do not presume complete elimination of a given risk factor.”
BackgroundClinical predictors of heart failure in patients with first acute myocardial infarction
Ali, A. S., Rybicki, B. A., Alam, M., Wulbrecht, N., Richer-Cornish, K., Khaja, F., Sabbah, H. N., & Goldstein, S. (1999) · American Heart Journal · doi:10.1016/s0002-8703(99)70080-3 · Cited by 104
Kawel‐Boehm, N., Kronmal, R. A., Eng, J., Folsom, A. R., Burke, G. L., Carr, J. J., Shea, S., Lima, J. A. C., & Bluemke, D. A. (2019) · Radiology · doi:10.1148/radiol.2019182871 · Cited by 103
“We had expected that regression models adjusted for CAC score would negate the effects of LV hypertrophy in relationship Radiology: Volume 293: Number 1—October 2019 n radiology.rsna.org 113 a mean of 3.5 years, Aronow and Ahn (36) found a higher incidence of HF in participants with ECG-diagnosed LV hypertrophy than i…”
MethodInfluentialHeart Failure in the Twenty-First Century: Is it a Coronary Artery Disease or Hypertension Problem?
Velagaleti, R. S., & Vasan, R. S. (2007) · Cardiology Clinics · doi:10.1016/j.ccl.2007.08.010 · Cited by 106
Gout and the risk for incident heart failure and systolic dysfunction
Krishnan, E. (2012) · BMJ Open · doi:10.1136/bmjopen-2011-000282 · Cited by 101
Ultrastructural uncoupling between T-tubules and sarcoplasmic reticulum in human heart failure
Zhang, H.-B., Li, R.-C., Xu, M. J., Xu, S.-M., Lai, Y.-S., Wu, H., Xie, X.-J., Gao, W., Ye, H., Zhang, Y., et al. (2013) · Cardiovascular Research · doi:10.1093/cvr/cvt030 · Cited by 101
Rasoul, S., Ottervanger, J. P., de Boer, M., Dambrink, J. E., Hoorntje, J. C. A., Gosselink, A. T. M., Zijlstra, F., Suryapranata, H., & Hof, A. W. J. V. ’. (2009) · Coronary Artery Disease · doi:10.1097/mca.0b013e32832e5c4c · Cited by 101
Pfister, R., Michels, G., Sharp, S. J., Luben, R., Wareham, N. J., & Khaw, K.-T. (2014) · European Journal of Heart Failure · doi:10.1002/ejhf.56 · Cited by 100
Komanduri, S., Jadhao, Y., Guduru, S., Cheriyath, P., & Wert, Y. (2017) · Journal of Community Hospital Internal Medicine Perspectives · doi:10.1080/20009666.2016.1264696 · Cited by 106
“1 years of follow-up, analysis of the study revealed that hypertension had a high attributable risk for HF, responsible for 59% of cases in women and 39% of cases in men [18].”
BackgroundSleep‐Disordered Breathing and Cardiovascular Disease in Children and Adolescents
Baker-Smith, C. M., Isaiah, A., Melendres, M. C., Mahgerefteh, J., Lasso‐Pirot, A., Mayo, S., Gooding, H. C., & Zachariah, J. P. V. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.121.022427 · Cited by 111
New insights into diastolic heart failure: role of diabetes mellitus
Piccini, J. P., Klein, L., Gheorghiade, M., & Bonow, R. O. (2004) · The American Journal of Medicine · doi:10.1016/j.amjmed.2003.10.021 · Cited by 100
Hepatocyte Growth Factor Reduces Cardiac Fibrosis by Inhibiting Endothelial-Mesenchymal Transition
Okayama, K., Azuma, J., Dosaka, N., Iekushi, K., Sanada, F., Kusunoki, H., Iwabayashi, M., Rakugi, H., Taniyama, Y., & Morishita, R. (2012) · Hypertension · doi:10.1161/hypertensionaha.111.183905 · Cited by 100
Banach, M., Bhatia, V., Feller, M. A., Mujib, M. U., Desai, R. V., Ahmed, M. I., Guichard, J. L., Aban, I., Love, T. E., Aronow, W. S., et al. (2011) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2010.12.020 · Cited by 100
Gerdts, E., Izzo, R., Mancusi, C., Losi, M. A., Manzi, M. V., Canciello, G., LUCA, N. D., Trimarco, B., & SIMONE, G. D. (2018) · International Journal of Cardiology · doi:10.1016/j.ijcard.2017.12.086 · Cited by 98
Wong, N. D., Thakral, G., Franklin, S. S., L’Italien, G. J., Jacobs, M. J., Whyte, J. L., & Lapuerta, P. (2003) · American Heart Journal · doi:10.1016/s0002-8703(02)94787-3 · Cited by 98
Sex-Specific Epidemiology of Heart Failure Risk and Mortality in Europe
Magnussen, C., Niiranen, T., Ojeda, F., Gianfagna, F., Blankenberg, S., Vartiainen, E. A., Sans, S., Pasterkamp, G., Hughes, M., Costanzo, S., et al. (2019) · JACC Heart Failure · doi:10.1016/j.jchf.2018.08.008 · Cited by 103
Metadata
- 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
- 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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