Lifetime Risk of Heart Failure Among Participants in the Framingham Study

The residual lifetime risk (RLR) of developing heart failure (HF) may have changed over time because of the increasing population burden of hypertension, obesity, and diabetes; greater survival after myocardial infarction; and a greater lifespan. The authors assessed changes in the RLR for HF in two...

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Vydané v:	Journal of the American College of Cardiology Ročník 79; číslo 3; s. 250
Hlavní autori:	Vasan, Ramachandran S, Enserro, Danielle M, Beiser, Alexa S, Xanthakis, Vanessa
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States 25.01.2022
Predmet:	Aged Aged, 80 and over Body Mass Index Cohort Studies Diabetes Mellitus - epidemiology Female Follow-Up Studies Heart Failure - epidemiology Humans Hypertension - epidemiology Incidence Life Expectancy Male Middle Aged Risk Assessment Risk Factors United States - epidemiology United States cohort studies epidemiology heart failure lifetime risk period effects
ISSN:	1558-3597, 1558-3597
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Abstract	The residual lifetime risk (RLR) of developing heart failure (HF) may have changed over time because of the increasing population burden of hypertension, obesity, and diabetes; greater survival after myocardial infarction; and a greater lifespan. The authors assessed changes in the RLR for HF in two 25-year epochs (1965-1989 and 1990-2014). We compared the RLR of HF at age 50 years (adjusting for competing risk of death) in the 2 epochs in Framingham Study participants overall and in the following strata: sex, body mass index, blood pressure, and diabetes. Mean life expectancy increased from 75.9 to 82.1 years in women and 72.5 to 78.1 years in men. We observed 624 HF events over 111,351 person-observations in epoch 1, and 875 HF events over 128,903 person-observations in epoch 2. The mean age at onset of HF increased across the epochs by 6.6 years (women) to 7.2 years (men). The RLR of HF at age 50 years increased across epochs from 18.86% to 22.55% (absolute increase 3.69; 95% CI: 0.90-6.49; P = 0.01) in women, and from 19.19% to 25.25% (absolute increase 6.06; 95% CI: 3.08-9.04; P < 0.001) in men. The increase in RLR of HF in the second epoch was consistent across strata with excess body mass index or higher blood pressure (relative increase of 28%-47%) and in participants without prior myocardial infarction (relative increase of 23%). The RLR of HF has increased in our community-based sample of White individuals over the last 5 decades, possibly caused by an increase in life expectancy.
AbstractList	The residual lifetime risk (RLR) of developing heart failure (HF) may have changed over time because of the increasing population burden of hypertension, obesity, and diabetes; greater survival after myocardial infarction; and a greater lifespan.BACKGROUNDThe residual lifetime risk (RLR) of developing heart failure (HF) may have changed over time because of the increasing population burden of hypertension, obesity, and diabetes; greater survival after myocardial infarction; and a greater lifespan.The authors assessed changes in the RLR for HF in two 25-year epochs (1965-1989 and 1990-2014).OBJECTIVESThe authors assessed changes in the RLR for HF in two 25-year epochs (1965-1989 and 1990-2014).We compared the RLR of HF at age 50 years (adjusting for competing risk of death) in the 2 epochs in Framingham Study participants overall and in the following strata: sex, body mass index, blood pressure, and diabetes.METHODSWe compared the RLR of HF at age 50 years (adjusting for competing risk of death) in the 2 epochs in Framingham Study participants overall and in the following strata: sex, body mass index, blood pressure, and diabetes.Mean life expectancy increased from 75.9 to 82.1 years in women and 72.5 to 78.1 years in men. We observed 624 HF events over 111,351 person-observations in epoch 1, and 875 HF events over 128,903 person-observations in epoch 2. The mean age at onset of HF increased across the epochs by 6.6 years (women) to 7.2 years (men). The RLR of HF at age 50 years increased across epochs from 18.86% to 22.55% (absolute increase 3.69; 95% CI: 0.90-6.49; P = 0.01) in women, and from 19.19% to 25.25% (absolute increase 6.06; 95% CI: 3.08-9.04; P < 0.001) in men. The increase in RLR of HF in the second epoch was consistent across strata with excess body mass index or higher blood pressure (relative increase of 28%-47%) and in participants without prior myocardial infarction (relative increase of 23%).RESULTSMean life expectancy increased from 75.9 to 82.1 years in women and 72.5 to 78.1 years in men. We observed 624 HF events over 111,351 person-observations in epoch 1, and 875 HF events over 128,903 person-observations in epoch 2. The mean age at onset of HF increased across the epochs by 6.6 years (women) to 7.2 years (men). The RLR of HF at age 50 years increased across epochs from 18.86% to 22.55% (absolute increase 3.69; 95% CI: 0.90-6.49; P = 0.01) in women, and from 19.19% to 25.25% (absolute increase 6.06; 95% CI: 3.08-9.04; P < 0.001) in men. The increase in RLR of HF in the second epoch was consistent across strata with excess body mass index or higher blood pressure (relative increase of 28%-47%) and in participants without prior myocardial infarction (relative increase of 23%).The RLR of HF has increased in our community-based sample of White individuals over the last 5 decades, possibly caused by an increase in life expectancy.CONCLUSIONSThe RLR of HF has increased in our community-based sample of White individuals over the last 5 decades, possibly caused by an increase in life expectancy. The residual lifetime risk (RLR) of developing heart failure (HF) may have changed over time because of the increasing population burden of hypertension, obesity, and diabetes; greater survival after myocardial infarction; and a greater lifespan. The authors assessed changes in the RLR for HF in two 25-year epochs (1965-1989 and 1990-2014). We compared the RLR of HF at age 50 years (adjusting for competing risk of death) in the 2 epochs in Framingham Study participants overall and in the following strata: sex, body mass index, blood pressure, and diabetes. Mean life expectancy increased from 75.9 to 82.1 years in women and 72.5 to 78.1 years in men. We observed 624 HF events over 111,351 person-observations in epoch 1, and 875 HF events over 128,903 person-observations in epoch 2. The mean age at onset of HF increased across the epochs by 6.6 years (women) to 7.2 years (men). The RLR of HF at age 50 years increased across epochs from 18.86% to 22.55% (absolute increase 3.69; 95% CI: 0.90-6.49; P = 0.01) in women, and from 19.19% to 25.25% (absolute increase 6.06; 95% CI: 3.08-9.04; P < 0.001) in men. The increase in RLR of HF in the second epoch was consistent across strata with excess body mass index or higher blood pressure (relative increase of 28%-47%) and in participants without prior myocardial infarction (relative increase of 23%). The RLR of HF has increased in our community-based sample of White individuals over the last 5 decades, possibly caused by an increase in life expectancy.
Author	Enserro, Danielle M Beiser, Alexa S Vasan, Ramachandran S Xanthakis, Vanessa
Author_xml	– sequence: 1 givenname: Ramachandran S surname: Vasan fullname: Vasan, Ramachandran S email: vasan@bu.edu organization: Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA; Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA. Electronic address: vasan@bu.edu – sequence: 2 givenname: Danielle M surname: Enserro fullname: Enserro, Danielle M organization: NRG Oncology; Clinical Trials Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA – sequence: 3 givenname: Alexa S surname: Beiser fullname: Beiser, Alexa S organization: Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA; Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA – sequence: 4 givenname: Vanessa surname: Xanthakis fullname: Xanthakis, Vanessa organization: Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA; Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA; Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
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Copyright	Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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SubjectTerms	Aged Aged, 80 and over Body Mass Index Cohort Studies Diabetes Mellitus - epidemiology Female Follow-Up Studies Heart Failure - epidemiology Humans Hypertension - epidemiology Incidence Life Expectancy Male Middle Aged Risk Assessment Risk Factors United States - epidemiology
Title	Lifetime Risk of Heart Failure Among Participants in the Framingham Study
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