Diabetes doubles heart failure risk
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Heart failure occurs more frequently among adults with type 2 diabetes vs. those without the disease and can be considered an independent risk factor for the condition, according to findings from a population study published in Mayo Clinic Proceedings.
“Participants with [diabetes] have an increased incidence of HF over a 10-year follow-up period even in the absence of underlying diastolic dysfunction,” Horng H. Chen, MD, MB BCh, professor of medicine and consultant in the division of circulatory failure of the department of cardiovascular diseases at Mayo Clinic in Rochester, Minnesota, and colleagues wrote. “These findings suggest that [diabetes] is an independent risk factor for the development of HF and supports the concept of [diabetic cardiomyopathy].”
Using data from 2,042 adults collected between June 1997 and September 2000 for the Rochester Epidemiology Project, Chen and colleagues identified 116 adults with diabetes (mean age, 66.6 years; 42% women) and 232 adults without diabetes matched for age, sex, diastolic function, and hypertension and coronary artery disease status (mean age, 66.6 years; 42% women). The researchers established baseline valvular pathology, cardiac structure, diastolic function and systolic function with echocardiography and followed participants for a mean of 10.8 years.
Participants with diabetes had significantly higher proportion of obesity (50% vs. 36%; P = .01) and mean BMI (29 kg/m2 vs. 31 kg/m2; P = .001), serum insulin (8.5 μU/mL vs 5.8 μU/mL; P ˂ .001) and serum glucose levels (130 mg/dL vs 95 mg/dL; P ˂ .001). Mean E/e’ was 9.7 for those with diabetes vs 8.5 for those without (P < .001). The researchers noted that when comparing groups, no variability was found for ejection fraction, left atrial size or diastolic dysfunction.
“These echocardiographic findings suggest that in our cohort, cardiac structure is similar between the two groups,” the researchers wrote. “Despite similar cardiac structure at baseline, the [diabetes] group had increased risk for the development of HF during the follow-up period, suggesting that [diabetes] is associated with the development of HF.”
HF occurred in 21% of participants with diabetes and 12% of without at 10 years. Compared with participants without diabetes, those with diabetes were at 2.1 times greater HF risk (HR = 2.1; 955 CI, 1.2-3.6).
Among participants without diastolic dysfunction, HF occurred in 13% of those with diabetes and 7% of those without diabetes at 10 years, for an HR of 2.5 (95% CI, 1-6.3).
“Diabetes is an independent risk factor and is associated with the development of HF over time,” the researchers wrote. “We have also shown that participants with [diabetes], even in the absence of diastolic dysfunction, are more likely than those without [diabetes] to develop HF.” – by Phil Neuffer
Disclosures: Chen reports that he is a co-founder of Zumbro Discovery. Please see the study for all other authors’ relevant financial disclosures.
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Klajda MD, et al. Mayo Clin Proc. 2019;doi:10.1016/j.mayocp.2019.07.008.
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