A stronger association exists between incident HF and certain modifiable risk factors in women than in men, researchers reported.
The modifiable risk factors in question included type 2 diabetes, hypercholesterolemia, watching television more than 3 hours per day and low levels of physical activity.
According to the study published in Heart, over a mean follow-up of 9 years, 0.3% of the total participants analyzed (n = 468,941, 56% women, aged between 37 and 73 years) developed HF. Of those who developed HF, 42% died as a result.
Researchers found that women with type 1 diabetes, type 2 diabetes, hypertension, hypercholesterolemia, low levels of physical activity and fitness, low strength, high levels of TV viewing, low sleep duration, smoke or drink more than 14 units of alcohol per week were at elevated risk for HF incidence.
“The early identification of women at risk of heart failure could be mediated by focusing on emerging modifiable risk factors, including physical activity, sleep duration and TV viewing alongside traditional risk factors including T1DM and T2DM, hypertension, hypercholesterolemia, smoking and alcohol consumption,” Anne Sillars, PhD, clinical research fellow at the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom, and colleagues wrote. “These emerging risk factors could be a useful clinical measurement used in conjunction with traditional methods to more specifically risk stratify patients in the clinical setting.”
Researchers used data collected from the UK Biobank study to assess HF incidence and mortality differences by sex and the association to risk factors including hypertension, hypercholesterolemia, type 1 and 2 diabetes, adiposity, smoking, physical activity and poor diet as well as novel risk factors that included grip strength, fitness, TV viewing and sleep duration; the primary outcomes were HF incidence and mortality.
Researchers concluded that modifiable risk factors including type 2 diabetes (HR for women vs. men = 1.73; 95% CI, 1.34-2.24), hypercholesterolemia (HR for women vs. men = 1.32; 95% CI, 1.06-1.63), more hours of TV viewing (HR for women vs. men for more than 3 hours per day = 1.59; 95% CI, 1.25-2.02) and low levels of physical activity (HR for women vs. men = 1.43; 95% CI, 1.02-2) had a stronger association with HF incidence in women compared with men. Those factors were also more strongly associated with HF mortality in women compared with men.
“The early identification of women at risk of HF could be mediated by focusing on these modifiable lifestyle risk factors in particular,” the authors wrote. “The relevance of these findings to differentiate HF characteristics by sex and future outcomes needs [to be] further established.” – by Scott Buzby
Disclosure: The authors report no relevant financial disclosures.