Laura P Cohen1, Eric Vittinghoff2, Mark J Pletcher2, Norrina B Allen3, Sanjiv J Shah3, John T Wilkins3, Patricia P Chang4, Chiadi E Ndumele5, Anne B Newman6, Diane Ives6, Mathew S Maurer1, Elizabeth C Oelsner1, Andrew E Moran1, Yiyi Zhang7. 1. Columbia University Irving Medical Center, Columbia University, New York, New York. 2. University of California, San Francisco, San Francisco, California. 3. Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 4. University of North Carolina School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 5. Johns Hopkins University Medical Center, Johns Hopkins University, Baltimore, Maryland. 6. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania. 7. Columbia University Irving Medical Center, Columbia University, New York, New York. Electronic address: yz3160@cumc.columbia.edu.
Abstract
BACKGROUND: Independent associations between cardiovascular risk factor exposures during midlife and later life development of heart failure (HF) with preserved ejection fraction (HFpEF) versus reduced EF (HFrEF) have not been previously studied. METHODS: We pooled data from 4 US cohort studies (Atherosclerosis Risk in Communities, Cardiovascular Health, Health , Aging and Body Composition, and Multi-Ethnic Study of Atherosclerosis) and imputed annual risk factor trajectories for body mass index, systolic and diastolic blood pressure, low-density lipoprotein and high-density lipoprotein cholesterol, and glucose starting from age 40 years. Time-weighted average exposures to each risk factor during midlife and later life were calculated and analyzed for associations with the development of HFpEF or HFrEF. RESULTS: A total of 23,861 participants were included (mean age at first in-person visit, 61.8 ±1 0.2 years; 56.6% female). During a median follow-up of 12 years, there were 3666 incident HF events, of which 51% had EF measured, including 934 with HFpEF and 739 with HFrEF. A high midlife systolic blood pressure and low midlife high-density lipoprotein cholesterol were associated with HFrEF, and a high midlife body mass index, systolic blood pressure, pulse pressure, and glucose were associated with HFpEF. After adjusting for later life exposures, only midlife pulse pressure remained independently associated with HFpEF. CONCLUSIONS: Midlife exposure to cardiovascular risk factors are differentially associated with HFrEF and HFpEF later in life. Having a higher pulse pressure during midlife is associated with a greater risk for HFpEF but not HFrEF, independent of later life exposures.
BACKGROUND: Independent associations between cardiovascular risk factor exposures during midlife and later life development of heart failure (HF) with preserved ejection fraction (HFpEF) versus reduced EF (HFrEF) have not been previously studied. METHODS: We pooled data from 4 US cohort studies (Atherosclerosis Risk in Communities, Cardiovascular Health, Health , Aging and Body Composition, and Multi-Ethnic Study of Atherosclerosis) and imputed annual risk factor trajectories for body mass index, systolic and diastolic blood pressure, low-density lipoprotein and high-density lipoprotein cholesterol, and glucose starting from age 40 years. Time-weighted average exposures to each risk factor during midlife and later life were calculated and analyzed for associations with the development of HFpEF or HFrEF. RESULTS: A total of 23,861 participants were included (mean age at first in-person visit, 61.8 ±1 0.2 years; 56.6% female). During a median follow-up of 12 years, there were 3666 incident HF events, of which 51% had EF measured, including 934 with HFpEF and 739 with HFrEF. A high midlife systolic blood pressure and low midlife high-density lipoprotein cholesterol were associated with HFrEF, and a high midlife body mass index, systolic blood pressure, pulse pressure, and glucose were associated with HFpEF. After adjusting for later life exposures, only midlife pulse pressure remained independently associated with HFpEF. CONCLUSIONS: Midlife exposure to cardiovascular risk factors are differentially associated with HFrEF and HFpEF later in life. Having a higher pulse pressure during midlife is associated with a greater risk for HFpEF but not HFrEF, independent of later life exposures.
Authors: Patrick Meagher; Mohamed Adam; Robert Civitarese; Antoinette Bugyei-Twum; Kim A Connelly Journal: Can J Cardiol Date: 2018-03-02 Impact factor: 5.223
Authors: L P Fried; N O Borhani; P Enright; C D Furberg; J M Gardin; R A Kronmal; L H Kuller; T A Manolio; M B Mittelmark; A Newman Journal: Ann Epidemiol Date: 1991-02 Impact factor: 3.797
Authors: Kelly McHugh; Adam D DeVore; Jingjing Wu; Roland A Matsouaka; Gregg C Fonarow; Paul A Heidenreich; Clyde W Yancy; Jennifer B Green; Natasha Altman; Adrian F Hernandez Journal: J Am Coll Cardiol Date: 2019-02-12 Impact factor: 24.094
Authors: Franz H Messerli; Giuseppe Mancia; C Richard Conti; Ann C Hewkin; Stuart Kupfer; Annette Champion; Rainer Kolloch; Athanase Benetos; Carl J Pepine Journal: Ann Intern Med Date: 2006-06-20 Impact factor: 25.391
Authors: Gina D Schellenbaum; Thomas D Rea; Susan R Heckbert; Nicholas L Smith; Thomas Lumley; Veronique L Roger; Dalane W Kitzman; Herman A Taylor; Daniel Levy; Bruce M Psaty Journal: Am J Epidemiol Date: 2004-10-01 Impact factor: 4.897
Authors: Matthew B Green; Daichi Shimbo; Joseph E Schwartz; Adam P Bress; Jordan B King; Paul Muntner; James P Sheppard; Richard J McManus; Ciaran N Kohli-Lynch; Yiyi Zhang; Steven Shea; Andrew E Moran; Brandon K Bellows Journal: Am J Hypertens Date: 2022-08-01 Impact factor: 3.080