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Raised Blood Pressure/BMI in Midlife Predicts Heart Failure in Later Life

Posted: Thursday, October 11, 2007

Raised blood pressure (BP) and excess body mass index (BMI) in middle age increases the risk of heart failure in later life, a new study suggests.

Dr Douglas Lee (University of Toronto, ON), conducted the study and concluded that their data, although observational, suggest that effective heart-failure prevention strategies are best conceived as lifelong initiatives, rather than as beginning in the seventh decade, at which point the risk of developing the condition begins to escalate.

Lee et al note that the incidence of heart failure increases exponentially in the seventh decade of life and beyond and is therefore often regarded as a disease of the elderly. Given the substantial adverse outcomes associated with heart failure, disease-management guidelines have emphasized the importance of prevention, but that the development of preventive strategies requires a better understanding of the key risk factors for heart failure and the evolution of these risk factors over the life course, they add.

They point out that although previous studies have greatly advanced the understanding of risk factors for heart failure, they have not evaluated the contribution of potential risk factors at an earlier point in the life course, such as in midlife. As it is widely accepted that cardiac remodeling evolves over time and, in response to risk factor exposures, Lee and colleagues used Framingham data to examine whether BP and BMI measures obtained over a period of two decades in the midlife period of study participants were related to the risk of heart failure during follow-up.

They studied 3362 Framingham participants (57% women; mean age 62 years) who attended routine examinations between 1969 and 1994 and examined their systolic and diastolic BP, pulse pressure, and BMI at various time periods during the past 20 years.

Results showed that during 67,240 person-years of follow-up, 518 participants developed heart failure. Current, recent, and remote systolic pressure; pulse pressure; and BMI were all individually associated with incident heart failure. The recent and remote associations remained after adjusting for current measurements.

Source: Diabetes In Control: Associations of Antecedent Blood Pressure With Incident Heart Failure