Hypertension affects nearly half of American adults, underscoring its critical role in preventing heart failure. New insights from the American Heart Association reveal that an estimated 15 million Americans may be at risk of developing heart failure. The PREVENT equations, developed by the association, offer a promising tool for predicting an individual's risk, providing a pathway for preemptive measures. Currently, approximately 6.7 million Americans live with heart failure, with Black Americans disproportionately affected.
Elevated hemoglobin A1c (HbA1c) levels, indicative of diabetes, emerge as a prevalent risk factor, particularly among Hispanic adults. Coupled with the detrimental impacts of cigarette smoking, these factors contribute significantly to the escalating risk of heart failure. The prevalence of a BMI over 30 kg/m² and systolic blood pressure above 130 mm Hg are also prevalent among those at heightened risk. Alarmingly, over 55% of individuals facing this risk have a BMI exceeding 30 kg/m², while about 53% exhibit systolic blood pressure above the threshold of 130 mm Hg.
The majority of those at elevated risk fall within the age bracket of 70 to 79 years. Notably, addressing high blood pressure could potentially cut the risk of heart failure by half. Diabetes is more prevalent among Hispanic Americans, which may explain its significant role in this group's heart failure risk profile. The PREVENT equations were formulated using survey data from 4,872 participants aged between 30 and 79 years, representing a cross-section of the American adult population.
In addition to these factors, the risk of heart failure is amplified for individuals with a family history of heart failure, exposure to toxic drugs, sleep apnea, and excessive alcohol consumption. These elements are critical in understanding the broader landscape of heart failure risk.
“High blood pressure, elevated BMI, and high HbA1c reflect the adverse effects of hypertension, obesity, and uncontrolled diabetes on the heart,” said Chiadi Ndumele, MD, PhD.
These conditions contribute to structural and functional heart deterioration, heightening heart failure risk. Despite these findings, many elderly people at risk lack any modifiable factors.
“Most of the elderly people found to be at risk [of heart failure] don’t have any of these modifiable factors,” stated Francisco Lopez-Jimenez, MD.
Addressing these concerns requires a comprehensive approach that combines education, access to preventive medical care, and lifestyle changes.
“This combined approach of maximizing education, access to preventive medical care, and support for the necessary lifestyle changes—quitting smoking, healthy diet, an exercise program—is critical for going after all the risk factors and preventing heart failure,” emphasized Hamilton.
The patterns observed in people at risk for heart failure align closely with those seen in patients already suffering from it.
“The patterns of people at risk for heart failure largely track with the same patterns seen in patients with heart failure,” observed Timothy Anderson, MD.
However, certain contributing factors are not always readily identifiable in large population databases. These less common contributors include family history and lifestyle factors such as excessive alcohol consumption and exposure to toxic substances.
“However, these are not always readily identified in large population databases and are less commonly contributors to heart failure risk in the [general] population,” noted Ndumele.
The findings underscore the need for targeted interventions focused on modifiable risk factors to reduce heart failure incidence. High BMI and elevated blood pressure remain predominant issues among those at heightened risk. Tackling these elements through lifestyle modifications could prove pivotal in mitigating risks associated with heart failure.
As the data indicates, nearly half of American adults grapple with hypertension—a condition intricately linked to heart failure. Effective management of this condition could significantly diminish the likelihood of heart-related complications. The PREVENT equations provide a robust framework for identifying individuals at elevated risk, enabling healthcare professionals to tailor interventions more effectively.
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