Association Between Cardiometabolic Comorbidity Burden and Outcomes in Heart Failure

Area of Science:

• Cardiology
• Metabolic Medicine
• Public Health

Background:

• Heart failure (HF) frequently co-occurs with cardiometabolic conditions such as obesity, diabetes, and hypertension.
• The prevalence of these comorbidities poses a significant challenge in managing HF patients.

Purpose of the Study:

• To investigate the association between the severity of cardiometabolic comorbidities and hospitalization rates in patients diagnosed with heart failure.
• To determine if a higher burden of uncontrolled cardiometabolic conditions correlates with increased hospital admissions for heart failure.

Main Methods:

• A retrospective analysis of electronic health records for adult patients (≥18 years) with HF.
• Patients were stratified based on the number of severe comorbidities: hypertension, diabetes, and obesity, defined by specific clinical thresholds (SBP ≥160 mmHg, HbA1c ≥8%, BMI ≥35 kg/m²).
• Cox regression models were employed to assess the risk of all-cause and HF-specific hospitalizations within one year, adjusting for various demographic and clinical factors. Analyses were stratified by HF type (preserved vs. reduced ejection fraction).

Main Results:

• The study included 26,800 HF patients, with 16% experiencing hospitalizations within one year.
• Individuals with one or two to three severely uncontrolled cardiometabolic comorbidities showed a significantly increased risk of all-cause hospitalization compared to those without comorbidities (HR 1.23 and 1.57, respectively).
• Similar associations were observed for heart failure hospitalizations, and these findings were consistent across HF with preserved and reduced ejection fraction subgroups.

Conclusions:

• An increased burden of severe cardiometabolic comorbidities is significantly associated with a higher risk of all-cause hospitalization in heart failure patients.
• These findings underscore the importance of aggressively managing and targeting uncontrolled cardiometabolic conditions to mitigate morbidity and reduce hospitalizations in the HF population.