HF in younger population tied to modifiable risk factors
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Hypertension, diabetes, a history of smoking and prior MI were significant risk factors for HF in people younger than 55 years compared with an older population, according to a study published in The BMJ.
“Risk factors had greater discriminatory value in predicting new onset of HF in younger than in older people,” Jasper Tromp, MD, research fellow with the National Heart Centre Singapore, and colleagues wrote.
The study population included 26,675 people without HF at baseline, stratified by age: younger than 55 years, 55 to 64 years, 65 to 74 years and 75 years or older.
During a median follow-up of 12.7 years, HF occurred in 1% of those younger than 55 years, 5% of those aged 55 to 64 years, 10% in those aged 65 to 74 years and 18% in those aged 75 years or older.
Among individuals with HF, 36% were classified as having preserved ejection fraction, 55% as having reduced ejection fraction and 9% as unclassified.
In the youngest group, among those who had HF, 32% had preserved ejection fraction, compared with 43% in the oldest group, the researchers wrote.
Compared with older participants, in younger participants, the following factors were more likely to contribute to HF: hypertension, diabetes, current smoking history and previous MI (P for interaction for all < .05), according to the researchers.
The researchers found that hypertension, for instance, was linked to a threefold increase in the risk for future HF in young participants (HR = 3.02; 95% CI, 2.1-4.34; P < .001) compared with a 1.4-fold risk in elderly participants (HR = 1.43; 95% CI, 1.13-1.81; P = .003).
Existing risk factors explained a greater percentage of overall population attributable risk for HF in the youngest group (75% vs. 53%) than in older participants, according to the researchers.
Researchers observed that the population attributable risks of obesity (21% vs. 13%), hypertension (35% vs. 23%), diabetes (14% vs. 7%) and current smoking (32% vs. 1%) were higher in the young compared with the older participants.
“These findings highlight the importance of preventive efforts across the adult life course,” the researchers wrote.
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