The association between glucose abnormalities and heart failure in the population-based Reykjavik study
Open accessAbstract
OBJECTIVE—Diabetes is an independent risk factor for heart failure, whereas the relation between heart failure and abnormal glucose regulation (AGR) needs further evaluation. We studied this combination in the Reykjavík Study. RESEARCH DESIGN AND METHODS—The Reykjavík Study, a population-based cohort study during 1967–1997, recruited 19,381 participants aged 33–84 years who were followed until 2002. Oral glucose tolerance tests and chest X-rays were obtained from all participants. Cases were defined in accordance with World Health Organization criteria for type 2 diabetes or AGR (impaired glucose tolerance or impaired fasting glucose) and European Society of Cardiology guidelines for heart failure. RESULTS—The overall prevalence of type 2 diabetes and heart failure was 0.5% in men and 0.4% in women, while AGR and heart failure were found in 0.7% of men and 0.6% of women. Among participants with normal glucose regulation, heart failure was diagnosed in 3.2% compared with 6.0 and 11.8% among those with AGR and type 2 diabetes, respectively. The prevalence of type 2 diabetes in the age-group 45–65 years increased in both sexes during the period (P for trend = 0.007). The odds ratio was 2.8 (95% CI 2.2–3.6) for the association between type 2 diabetes and heart failure and 1.7 (1.4–2.1) between AGR and heart failure. CONCLUSIONS—There is a strong association between any form of glucometabolic perturbation and heart failure. Future studies in this field should focus on all types of glucose abnormalities rather than previously diagnosed diabetes only.
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Observational studies have consistently demonstrated a two- to four-fold increased risk of heart failure in individuals with diabetes compared with those without diabetes.
“Observational studies have consistently demonstrated a two-to four-fold increased risk of HF in individuals with diabetes compared with those without diabetes.[460][461][462][463]”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [461]
Unrecognized heart failure is frequent in type 2 diabetes: in a cross-sectional study of patients aged 60 years or older with type 2 diabetes without known heart failure, heart failure was present in 28% of patients, about 25% HFrEF and about 75% HFpEF.
“Unrecognized HF is frequent in T2DM: a cross-sectional study in patients aged ≥60 years with T2DM without known HF using a standardized diagnostic work-up, including medical history, physical examination, ECG, and echocardiography, indicated that HF was present in 28% of patients (∼25% HFrEF and ∼75% HFpEF).[460][461][462][463][464]”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [461]
Marked regional differences in T2DM prevalence in HF have been observed both in Europe and in the rest of the world.
“marked regional differences have been observed both in Europe and in rest of the world.”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [9]
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References 23 · Cited by 374
Research works printed but not linked: 1
- World Health Organization: MONICA Project. MONICA Manual, Revised Edition. Geneva, World Health Org., 1980
- Authors
- Thrainsdottir, I. S., Aspelund, T., Thorgeirsson, G., Gudnason, V., Hardarson, T., Malmberg, K., Sigurdsson, G., & Rydén, L.
- Affiliations
- Karolinska University Hospital (SE)
- Icelandic Heart Association (IS)
- Icelandic Heart Association, Reykjavík, Iceland
- National University Hospital of Iceland (IS)
- Department of Cardiology, Karolinska University Hospital Solna, Stockholm, Sweden
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2005-03-01
- Volume
- 28
- Issue
- 3
- Pages
- 612-616
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2090260921
- Cited by
- 374
- References
- 23
- Citations by year
- 2026: 10 · 2025: 15 · 2024: 26 · 2023: 26 · 2022: 27 · 2021: 32 · 2020: 49 · 2019: 32 · 2018: 17 · 2017: 16 · 2016: 10 · 2015: 9 · 2014: 20 · 2013: 15 · 2012: 10
- FWCI
- 5.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- Funders
- AFA Försäkring
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- heart failure, type 2 diabetes, prediabetes, impaired glucose tolerance, impaired fasting glucose, abnormal glucose metabolism, Reykjavik Study, prevalence, risk factors
- MeSH terms
- Adult, Aged, Blood Glucose, Diabetes Mellitus, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Heart Failure, Humans, Iceland, Male, Middle Aged, Reference Values, Prevalence
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