Key result
Baseline metabolic syndrome was associated with an increased risk of incident preclinical heart failure compared to no baseline metabolic syndrome (aOR 2.27; 95% CI 1.07-4.81).
Why the study?
The study evaluated the association between metabolic syndrome and incident preclinical heart failure in people initially free of clinical cardiovascular disease.
Does metabolic syndrome increase the risk of preclinical heart failure in adults initially free of cardiovascular disease?
Cohort (n=944)
No
Does metabolic syndrome increase the risk of preclinical heart failure in adults initially free of cardiovascular disease?
Metabolic syndrome, particularly with hypertension and elevated waist circumference, significantly increases the long-term risk of developing preclinical heart failure in individuals initially free of cardiovascular disease.
MS signals elevated preclinical HF risk in primary prevention cohorts; leaves open whether targeting obese-hypertensive phenotypes prevents progression.
BACKGROUND: We used data from people initially free of clinical cardiovascular disease to evaluate the association between metabolic syndrome (MS) and incident preclinical heart failure (pHF). METHODS AND RESULTS: STANISLAS was a familial, single-center, longitudinal prospective cohort study composed of 1,006 families from Nancy, France (median follow-up, 17 years [1993-2016]). Age- and sex-adjusted logistic regression and inverse probability weighting models were used to evaluate the association between MS and pHF, which was defined by diastolic dysfunction, atrial enlargement, ventricular hypertrophy, or elevated natriuretic peptides. Among 944 people who were adults at the first and final visit, those with baseline MS were more likely to be older (63 vs. 61 vs. 59 years of age) and male (73% vs. 55% vs. 45%) compared to people who developed incident MS and people who had no baseline MS, respectively. Furthermore, compared to people without baseline MS, the risk of pHF was numerically larger among people with baseline MS (adjusted odds ratio [aOR] 2.27, 95% CI: 1.07-4.81) and people who developed incident MS (aOR 1.56, 95% CI: 1.00-2.43). Concerning the metabolic determinants of MS, the risk of pHF was most elevated in people with baseline hypertension (aOR 3.19, 95% CI: 1.80-5.63) and elevated waist circumference (aOR 2.59, 95% CI: 1.47-4.57). CONCLUSION: Overall, HF is an important public health concern given the high risk of mortality when patients with MS or elevated fasting glucose become established with the disease. Early aggressive lifestyle modification and medical intervention among patients free of cardiovascular disease with an obese-hypertensive phenotype may be warranted to prevent HF development.
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Sharma et al. (2022) conducted a cohort in Preclinical heart failure (n=944). Baseline metabolic syndrome vs. No baseline metabolic syndrome was evaluated on Incident preclinical heart failure (pHF) (aOR 2.27, 95% CI 1.07-4.81). Baseline metabolic syndrome was associated with an increased risk of incident preclinical heart failure compared to no baseline metabolic syndrome (aOR 2.27; 95% CI 1.07-4.81).
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