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Well-Known and Novel Behavioural Risk Factors for Heart Failure
Natalia Kusyn1,2, Natalia Zdebik1, Wojciech Hajdusianek1
1Department of Environmental Health, Occupational Medicine and Epidemiology, Wroclaw Medical University, Mikulicza-Radeckiego 7, 50-345 Wrocław, Poland.
Insights
Lifestyle choices like smoking, poor diet, and inactivity significantly impact heart failure (HF) risk and progression. Understanding these behavioral factors and their mechanisms is key for preventing HF and guiding future research.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Heart failure (HF) affects millions globally, with ischemic heart disease as a primary cause.
- Behavioral and lifestyle factors play a crucial role in HF onset and progression.
- Established and emerging risk factors require comprehensive review.
Purpose of the Study:
- To review established and novel behavioral risk factors for heart failure.
- To explore the underlying pathophysiological mechanisms of these risk factors.
- To identify targets for primary prevention and future research directions.
Main Methods:
- Literature review of epidemiological data and pathophysiological insights.
- Focus on established risk factors: smoking, alcohol, obesity, inactivity, diet, sleep disorders, stress.
- Inclusion of novel determinants: electronic nicotine delivery systems (ENDS), cannabis, caffeine, psychostimulants.
Main Results:
- Behavioral factors significantly influence HF development and worsening.
- Mechanisms include endothelial dysfunction, oxidative stress, neurohormonal activation, and myocardial toxicity.
- Evidence supports a link between various lifestyle choices and HF.
Conclusions:
- Behavioral factors are critical targets for heart failure primary prevention.
- Further research is needed to elucidate mechanisms and refine preventive strategies.
- Integrating epidemiological and pathophysiological data is essential for combating HF.
Abstract:
Heart failure (HF) is a clinical syndrome characterized by structural or functional cardiac abnormalities that impair ventricular filling or ejection, leading to inadequate systemic perfusion and elevated intracardiac pressures. Current epidemiological estimations declare approximately 26 million patients affected worldwide are living with HF. While ischemic heart disease remains the primary etiology, there is a wide range of behavioural factors that significantly influence disease onset and progression. This review focuses on the evidence for established risk factors, including smoking, excessive alcohol consumption, obesity, physical inactivity, poor diet, sleep disorders, and psychological stress. Furthermore, we discuss other novel determinants such as electronic nicotine delivery systems (ENDS), cannabis, high-dose caffeine, and psychostimulants. The basic mechanistic pathways, including endothelial dysfunction, oxidative stress, neurohormonal activation, and direct myocardial toxicity, are also pointed out and reviewed in this paper. The aim of this study is to integrate epidemiological data with pathophysiological insights to identify priority targets for primary prevention and highlight areas for future research.
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