Hypertension was the dominant precursor to congestive heart failure, preceding it in 75% of cases and resulting in a 6-fold higher incidence compared to normotensive individuals over 16 years.
Cohort (n=5,192)
Does hypertension increase the risk of developing congestive heart failure in a general population sample?
Hypertension is the dominant etiologic precursor to congestive heart failure, highlighting the critical need for early and sustained blood pressure control to prevent CHF.
A representative population sample of 5192 men and women was followed for 16 years, during which overt congestive heart failure (CHF) developed in 142. In the age range from 30 to 62 years the dominant etiologic precursor was hypertension, which preceded CHF in 75 per cent of the cases. Six times more CHF developed in hypertensive than in normotensive persons. Examination of the association of myocardial hypertrophy on x-ray or electrocardiographic study with systolic versus diastolic pressure revealed little to suggest a greater role for diastolic pressure. Systolic and diastolic pressure together, mean arterial pressure, pulse pressure, and tension-time index discriminated potential hypertrophy and CHF no better than systolic pressure alone. Examination of the correlation of heart weight and left ventricular thickness at autopsy with premorbid systolic versus diastolic pressure revealed a better correlation with systolic than with diastolic pressure. CHF was a lethal phenomenon, with only 50 per cent surviving for five years. Early, vigorous and sustained control of elevated blood pressure — systolic as well as diastolic — appears the chief means for preventing CHF in the general population.
Kannel et al. (1972) conducted a cohort in Congestive heart failure (n=5,192). Hypertension vs. Normotension was evaluated on Development of overt congestive heart failure (CHF). Hypertension was the dominant precursor to congestive heart failure, preceding it in 75% of cases and resulting in a 6-fold higher incidence compared to normotensive individuals over 16 years.