Key result
Diabetes (RR 2.9; 95% CI 2.0-4.3), incident myocardial infarction (RR 21; 95% CI 15-31), and other traditional risk factors were independent predictors of incident heart failure in older adults.
Cohort (n=1,749)
In an elderly community-based cohort, male sex, older age, diabetes, elevated pulse pressure, and higher body mass index were identified as independent predictors of incident heart failure.
Traditional risks including diabetes and intercurrent MI predict incident HF in older adults; extends cohort data but leaves open need for trials.
PURPOSE: The risk factors for the development of heart failure are not clearly defined, particularly for older adults. We undertook the current investigation to examine the associations of traditional cardiovascular risk factors, comorbidity, and psychosocial factors with the risk of heart failure during 10 years of follow-up in a community-based elderly population. SUBJECTS AND METHODS: We evaluated 1,749 subjects, 65 years of age or older, free of heart failure, myocardial infarction, and angina at baseline, who were participating in the New Haven, Connecticut cohort of the Established Population for Epidemiologic Studies of the Elderly program. Cox proportional hazards regression models were used to determine risk ratios (RR) and 95% confidence intervals (CI). RESULTS: During 13,811 person-years of follow-up, 173 subjects developed incident heart failure, as confirmed by chart review. Five factors were independent predictors of heart failure: male sex (RR = 1.7; CI, 1.3 to 2.4), older age (RR = 1.9; CI, 1.3 to 2.7 for age 75 to 84 years, RR = 3.0; CI, 1.7 to 5.5 for age 85 years and older, compared with < or = 74 years), diabetes (RR = 2.9; CI, 2.0 to 4.3), pulse pressure > or = 70 mm Hg (RR = 2.3; CI, 1.3 to 4.3, compared with <50 mm Hg), and body mass index > or = 28 kg/m2 (RR = 1.6; CI, 1.0 to 2.4, compared with <24 kg/ m2). Myocardial infarction occurred during follow-up in 8% of the cohort and was also an important predictor of heart failure (RR = 21; CI, 15 to 31). CONCLUSIONS: Age and traditional cardiovascular risk factors are associated with the development of heart failure in the elderly. Preventive strategies should focus on the management of diabetes, blood pressure, and weight, in addition to the prevention and management of myocardial infarction.
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Chen et al. (1999) conducted a cohort in Heart failure (n=1,749). Diabetes vs. Absence of diabetes was evaluated on Incident heart failure (RR 2.9, 95% CI 2.0-4.3). Diabetes (RR 2.9; 95% CI 2.0-4.3), incident myocardial infarction (RR 21; 95% CI 15-31), and other traditional risk factors were independent predictors of incident heart failure in older adults.
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