Risk factors for heart failure in the elderly: a prospective community-based study
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PURPOSE: The risk factors for the development of heart failure are not clearly defined, particularly for older adults. We undertook the current investigation to examine the associations of traditional cardiovascular risk factors, comorbidity, and psychosocial factors with the risk of heart failure during 10 years of follow-up in a community-based elderly population. SUBJECTS AND METHODS: We evaluated 1,749 subjects, 65 years of age or older, free of heart failure, myocardial infarction, and angina at baseline, who were participating in the New Haven, Connecticut cohort of the Established Population for Epidemiologic Studies of the Elderly program. Cox proportional hazards regression models were used to determine risk ratios (RR) and 95% confidence intervals (CI). RESULTS: During 13,811 person-years of follow-up, 173 subjects developed incident heart failure, as confirmed by chart review. Five factors were independent predictors of heart failure: male sex (RR = 1.7; CI, 1.3 to 2.4), older age (RR = 1.9; CI, 1.3 to 2.7 for age 75 to 84 years, RR = 3.0; CI, 1.7 to 5.5 for age 85 years and older, compared with < or = 74 years), diabetes (RR = 2.9; CI, 2.0 to 4.3), pulse pressure > or = 70 mm Hg (RR = 2.3; CI, 1.3 to 4.3, compared with <50 mm Hg), and body mass index > or = 28 kg/m2 (RR = 1.6; CI, 1.0 to 2.4, compared with <24 kg/ m2). Myocardial infarction occurred during follow-up in 8% of the cohort and was also an important predictor of heart failure (RR = 21; CI, 15 to 31). CONCLUSIONS: Age and traditional cardiovascular risk factors are associated with the development of heart failure in the elderly. Preventive strategies should focus on the management of diabetes, blood pressure, and weight, in addition to the prevention and management of myocardial infarction.
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In human studies, conclusions are not firm regarding the direct role of obesity in the development of heart failure.
“However, in human studies, we mainly have to rely on cross-sectional data at this time, and the conclusions are not firm regarding the direct role of obesity in the development of heart failure (14, 46, 132, 376).”
From Cardiac remodeling in obesity (2008) · cites this paper as [46]
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- Authors
- Chen, Y.-T., Vaccarino, V., Williams, C. S., Butler, J., Berkman, L. F., & Krumholz, H. M.
- Affiliations
- Yale University (US)
- Vanderbilt University (US)
- Harvard University (US)
- Yale New Haven Hospital (US)
- Corresponding author
- Krumholz, Harlan M
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 1999-06
- Volume
- 106
- Issue
- 6
- Pages
- 605-612
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2041631957
- Cited by
- 256
- References
- 42
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 6 · 2020: 10 · 2019: 6 · 2018: 5 · 2017: 11 · 2016: 6 · 2015: 12 · 2014: 8 · 2013: 11 · 2012: 13
- FWCI
- 7.51
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The American Journal of Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Yale University
- National Institutes of Health
- National Institute on Aging (R01-AG-11042, 1T-32-AG-0-0153)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- heart failure, older adults, risk factors, cardiovascular risk factors, diabetes mellitus, pulse pressure, body mass index, myocardial infarction, comorbidities, psychosocial factors, sex differences, age, blood pressure, weight
- MeSH terms
- Aged, Aged, 80 and over, Blood Pressure, Connecticut, Depression, Female, Heart Failure, Humans, Male, Prospective Studies, Risk, Risk Factors, Socioeconomic Factors, Comorbidity, Body Mass Index, Incidence, Prevalence, Multivariate Analysis, Odds Ratio
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