The residual lifetime risk of heart failure at age 50 increased significantly between 1965-1989 and 1990-2014, with absolute increases of 3.69% in women (P=0.01) and 6.06% in men (P<0.001).
Cohort
Has the residual lifetime risk of heart failure changed between 1965-1989 and 1990-2014 in Framingham Study participants?
The residual lifetime risk of heart failure has significantly increased over the last five decades, likely driven by increased life expectancy.
Effect estimate: Absolute increase 3.69% (women), 6.06% (men) (95% CI 0.90-6.49 (women), 3.08-9.04 (men))
p-value: p=0.01 (women), <0.001 (men)
Background. The residual lifetime risk (RLR) of developing heart failure (HF) may have changed over time due to the increasing population burden of hypertension, obesity, and diabetes, greater survival after myocardial infarction (MI), and a greater lifespan. Objective. We assessed changes in the RLR for HF in two 25-year epochs (1965-1989; 1990-2014). Methods. We compared the RLR of HF at age 50 (adjusting for competing risk of death) in the two epochs in Framingham Study participants overall, and in the following strata: sex, body mass index (BMI), blood pressure (BP), and diabetes. Results: Mean life expectancy increased from 75.9 to 82.1 years in women and 72.5 to 78.1 years in men. We observed 624 HF events over 111,351 person-observations in epoch 1, and 875 HF events over 128,903 person-observations in epoch 2. The mean age at onset of HF increased across the epochs by 6.6 (women) to 7.7 (men) years. The RLR of HF at age 50 increased across epochs from 18.86 to 22.55 percent (absolute increase 3.69, 95% CI 0.90-6.49, p=0.01) in women, and from 19.19 to 25.25 percent (absolute increase 6.06, 95% CI 3.08-9.04, p<0.001) in men. The increase in RLR of HF in the second epoch was consistent across strata with excess BMI or higher BP (relative increase of 28-47%) and in participants without prior MI (relative increase of 23%). Conclusions. The RLR of HF has increased in our community-based sample of white individuals over the last five decades, possibly due to an increase in life expectancy.
“We know that obesity and overweight are associated with several health hazards. For example, they increase the risk of high blood pressure and diabetes, both key risk factors for heart failure. We found that even after accounting for these other risk factors, obesity was independently associated with the risk of heart failure.”
Vasan et al. (Sat,) conducted a cohort in Heart failure. Epoch 1990-2014 vs. Epoch 1965-1989 was evaluated on Residual lifetime risk of heart failure at age 50 (Absolute increase 3.69% (women), 6.06% (men), 95% CI 0.90-6.49 (women), 3.08-9.04 (men), p=0.01 (women), <0.001 (men)). The residual lifetime risk of heart failure at age 50 increased significantly between 1965-1989 and 1990-2014, with absolute increases of 3.69% in women (P=0.01) and 6.06% in men (P<0.001).