Evidence-Based Diabetes Management May 2015
Study of Heart Failure Patients Defines How Avoiding Risk Factors Can Add Years to Life
How much does avoiding risk factors like obesity, diabetes, and hypertension in your 30s and 40s matter? A lot, it turns out. According to a study presented dur-ing the 64th Annual Scientific Sessions of the American College of Cardiology (ACC), persons who had all 3 risk factors by the age of 45 years were diagnosed with heart failure 11 to 13 years earlier than those without those risk factors.
Results of the study were released March 5, 2015, in advance of the an-nual meeting held March 14-16, 2015, in San Diego. The study also found that persons who had 1 or 2, but not all 3, of the risk factors developed heart failure an average of 3 to 11 years earlier that those without any of the risk factors.
Faraz Ahmad, MD, a Northwestern University cardiology fellow and the study’s lead author, said the ability to quantify how much risk factors affect life span gives physicians a powerful message to bring to patients. “You really want to prevent or delay the onset of these risk factors for as long as possible,” Ahmad said in a statement released by the ACC.
Heart failure means the heart cannot pump enough blood for the body to function properly. Once the condition is diagnosed, other health problems can multiply; patients can experience organ failure, fatigue, swelling, coughing, and wheezing. According to the ACC, about half of patients with heart failure die within 5 years of diagnosis.
To calculate how the onset of risk factors affects life-span, researchers pooled results from large studies that together covered 18,280 patients and spanned a total of 40 years: the Framingham Heart, Framingham Offspring, Chicago Heart Association Detection Project in Industry, and Atherosclerosis Risk in Communities studies. All participants were free of cardiovascular disease at baseline.
The researchers were able to identify 1449 heart failure events over 471,988 person-years of follow-up. Men and women without hypertension, obesity, or diabetes mellitus lived on average 35.3 and 37.0 years without heart failure, respectively.
Compared with the study subjects with no risk factors, those with hypertension, obesity, and or diabetes mellitus at baseline had fewer years of heart failure survival: 3 versus 11. Men and women without hypertension, obesity, or diabetes mellitus at age 45 years lived on average 11.3 to 12.7 years longer free of heart failure than those with all 3 risk factors.
Besides giving physicians powerful information for patients, Ahmad said the results would help policy makers and public health officials predict fu-ture heart failure prevalence as the US population ages. According to the CDC, 5 million people have the disease, which costs the nation an estimated $32 billion annually in healthcare services, medication, and missed days of work.
Ahmad FS, Ning H, Rich J, Lloyd-Jones D, Wilkins J. Hypertension, obesity, diabetes, and heart-failure free survival: the cardiovascular lifetime risk pooling project. Presented at the 64th Annual Scientific Sessions of the American College of Cardiology; March 14-16, 2015; San Diego, CA.