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Sex differences in the association of risk factors for heart failure incidence and mortality

Anne Sillars1, Frederick K Ho2, Gill P Pell2

  • 1British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK anne.sillars@gla.ac.uk.

Heart (British Cardiac Society)
|August 2, 2019
PubMed

Insights

Heart failure risk factors differ by sex, with diabetes, hypercholesterolemia, and lifestyle factors like TV viewing and sleep duration more strongly associated with heart failure incidence in women. Further research is needed to confirm these findings.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Established risk factors for heart failure (HF) exist, but their differential impact based on sex remains unclear.
  • Understanding sex-specific risk factors is crucial for targeted prevention strategies.
  • Previous research has not fully elucidated the nuances of sex-based differences in HF development.

Purpose of the Study:

  • To investigate potential sex differences in risk factors contributing to heart failure (HF) incidence.
  • To examine the association between various established and novel risk factors and HF mortality across sexes.
  • To identify specific risk factors that may pose a greater threat to women's cardiovascular health.

Main Methods:

  • A large cohort study including 468,941 participants (55.9% women, aged 37-73 years) was analyzed.
  • Exposures included established cardiovascular disease (CVD) risk factors (e.g., hypertension, diabetes) and novel factors (e.g., grip strength, sleep duration).
  • Heart failure incidence and mortality were tracked over a mean follow-up of 9.0 years.

Main Results:

  • Over 1800 cases of HF incidence and 763 deaths were recorded.
  • Women exhibited increased HF risk associated with type 1 and type 2 diabetes, hypertension, hypercholesterolemia, low physical activity, low grip strength, prolonged TV viewing, short sleep duration, smoking, underweight, obesity, high body surface area, and high alcohol consumption.
  • Type 2 diabetes, hypercholesterolemia, excessive TV viewing (>3 hours/day), short sleep duration (<7 hours/day), and low physical activity showed a stronger association with HF incidence in women compared to men.

Conclusions:

  • Several modifiable risk factors, particularly diabetes, demonstrate a stronger association with heart failure in women compared to men.
  • These findings highlight the importance of considering sex-specific risk profiles in HF prevention and management.
  • Further investigation is warranted to establish the clinical relevance of these sex-based differences in HF characteristics and long-term outcomes.
Abstract

Keywords:
epidemiologyheart failureobesity

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