Circulation. 2002;106:3068-3072
Published online before print November 4, 2002, doi: 10.1161/01.CIR.0000039105.49749.6F
Published online before print November 4, 2002, doi: 10.1161/01.CIR.0000039105.49749.6F
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(Circulation. 2002;106:3068.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Lifetime Risk for Developing Congestive Heart Failure
The Framingham Heart Study
From the National Heart, Lung, and Blood Institute’s Framingham Heart Study, National Institutes of Health (NIH/NHLBI contract N01-HC-25195; D.M.L.-J., M.G.L., W.B.K., J.M.M., R.S.V., E.J.B., D.L.); Cardiology Division (D.M.L.-J.), Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Department of Epidemiology and Preventive Medicine (D.M.L.-J., M.G.L., R.B.D., W.B.K., E.J.B., R.S.V., D.L.), Cardiology Department (R.S.V., E.J.B.), and Section of General Internal Medicine (J.M.M.), Boston University School of Medicine, Boston, Mass; and Department of Epidemiology and Biostatistics (E.P.L., A.B., R.B.D.), Boston University School of Public Health, Boston, Mass.
Correspondence to Donald M. Lloyd-Jones, MD, Framingham Heart Study, 73 Mt Wayte Ave, Framingham, MA 01702. E-mail don{at}fram.nhlbi.nih.gov
Background— Congestive heart failure (CHF) is an increasing public health problem.
Methods and Results— Among Framingham Heart Study subjects who were free of CHF at baseline, we determined the lifetime risk for developing overt CHF at selected index ages. We followed 3757 men and 4472 women from 1971 to 1996 for 124 262 person-years; 583 subjects developed CHF and 2002 died without prior CHF. At age 40 years, the lifetime risk for CHF was 21.0% (95% CI 18.7% to 23.2%) for men and 20.3% (95% CI 18.2% to 22.5%) for women. Remaining lifetime risk did not change with advancing index age because of rapidly increasing CHF incidence rates. At age 80 years, the lifetime risk was 20.2% (95% CI 16.1% to 24.2%) for men and 19.3% (95% CI 16.5% to 22.2%) for women. Lifetime risk for CHF doubled for subjects with blood pressure 
160/100 versus <140/90 mm Hg. In a secondary analysis, we only considered those who developed CHF without an antecedent myocardial infarction; at age 40 years, the lifetime risk for CHF was 11.4% (95% CI 9.6% to 13.2%) for men and 15.4% (95% CI 13.5% to 17.3%) for women.
Conclusions— When established clinical criteria are used to define overt CHF, the lifetime risk for CHF is 1 in 5 for both men and women. For CHF occurring in the absence of myocardial infarction, the lifetime risk is 1 in 9 for men and 1 in 6 for women, which highlights the risk of CHF that is largely attributable to hypertension. These results should assist in predicting the population burden of CHF and placing greater emphasis on prevention of CHF through hypertension control and prevention of myocardial infarction.
Key Words: heart failure • risk factors • hypertension • myocardial infarction
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W. J. Remme, J. J.V. McMurray, B. Rauch, F. Zannad, K. Keukelaar, A. Cohen-Solal, J. Lopez-Sendon, F.D. R. Hobbs, D. E. Grobbee, A. Boccanelli, et al. Public awareness of heart failure in Europe: first results from SHAPE Eur. Heart J., November 2, 2005; 26(22): 2413 - 2421. [Abstract] [Full Text] [PDF]
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A. Schuchert and On behalf of the BISEX Investigators (Appendix A) Effects of bisoprolol treatment for chronic heart failure initiated and followed up by primary care physicians Eur J Heart Fail, June 1, 2005; 7(4): 604 - 611. [Abstract] [Full Text] [PDF]
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J. G.F. Cleland, A. A. Louis, A. S. Rigby, U. Janssens, A. H.M.M. Balk, and TEN-HMS Investigators Noninvasive Home Telemonitoring for Patients With Heart Failure at High Risk of Recurrent Admission and Death: The Trans-European Network-Home-Care Management System (TEN-HMS) study J. Am. Coll. Cardiol., May 17, 2005; 45(10): 1654 - 1664. [Abstract] [Full Text] [PDF]
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D. J. Campbell, M. Woodward, J. P. Chalmers, S. A. Colman, A. J. Jenkins, B. E. Kemp, B. C. Neal, A. Patel, and S. W. MacMahon Prediction of Heart Failure by Amino Terminal-pro-B-Type Natriuretic Peptide and C-Reactive Protein in Subjects With Cerebrovascular Disease Hypertension, January 1, 2005; 45(1): 69 - 74. [Abstract] [Full Text] [PDF]
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M. D. Sosin, G. S. Bhatia, R. C. Davis, and G. Y.H. Lip Heart failure--the importance of ethnicity Eur J Heart Fail, December 1, 2004; 6(7): 831 - 843. [Abstract] [Full Text] [PDF]
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K. Bibbins-Domingo, F. Lin, E. Vittinghoff, E. Barrett-Connor, D. Grady, and M. G. Shlipak Renal insufficiency as an independent predictor of mortality among women with heart failure J. Am. Coll. Cardiol., October 19, 2004; 44(8): 1593 - 1600. [Abstract] [Full Text] [PDF]
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K. Bibbins-Domingo, F. Lin, E. Vittinghoff, E. Barrett-Connor, S. B. Hulley, D. Grady, and M. G. Shlipak Predictors of Heart Failure Among Women With Coronary Disease Circulation, September 14, 2004; 110(11): 1424 - 1430. [Abstract] [Full Text] [PDF]
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F. A. McAlister, J. A. Ezekowitz, N. Wiebe, B. Rowe, C. Spooner, E. Crumley, L. Hartling, T. Klassen, and W. Abraham Systematic Review: Cardiac Resynchronization in Patients with Symptomatic Heart Failure Ann Intern Med, September 7, 2004; 141(5): 381 - 390. [Abstract] [Full Text] [PDF]
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R. Querejeta, B. Lopez, A. Gonzalez, E. Sanchez, M. Larman, J. L. Martinez Ubago, and J. Diez Increased Collagen Type I Synthesis in Patients With Heart Failure of Hypertensive Origin: Relation to Myocardial Fibrosis Circulation, September 7, 2004; 110(10): 1263 - 1268. [Abstract] [Full Text] [PDF]
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G. S. Bleumink, A. M. Knetsch, M. C.J.M. Sturkenboom, S. M.J.M. Straus, A. Hofman, J. W. Deckers, J. C.M. Witteman, and B. H.Ch. Stricker Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure: The Rotterdam Study Eur. Heart J., September 2, 2004; 25(18): 1614 - 1619. [Abstract] [Full Text] [PDF]
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D. M. Lloyd-Jones, T. J. Wang, E. P. Leip, M. G. Larson, D. Levy, R. S. Vasan, R. B. D'Agostino, J. M. Massaro, A. Beiser, P. A. Wolf, et al. Lifetime Risk for Development of Atrial Fibrillation: The Framingham Heart Study Circulation, August 31, 2004; 110(9): 1042 - 1046. [Abstract] [Full Text] [PDF]
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G. A. Nichols, C. M. Gullion, C. E. Koro, S. A. Ephross, and J. B. Brown The Incidence of Congestive Heart Failure in Type 2 Diabetes: An update Diabetes Care, August 1, 2004; 27(8): 1879 - 1884. [Abstract] [Full Text] [PDF]
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J. I. Barzilay, R. A. Kronmal, J. S. Gottdiener, N. L. Smith, G. L. Burke, R. Tracy, P. J. Savage, and M. Carlson The association of fasting glucose levels with congestive heart failure in diabetic adults >=65 years: The Cardiovascular Health Study J. Am. Coll. Cardiol., June 16, 2004; 43(12): 2236 - 2241. [Abstract] [Full Text] [PDF]
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M. R. Zile, C. F. Baicu, and W. H. Gaasch Diastolic Heart Failure -- Abnormalities in Active Relaxation and Passive Stiffness of the Left Ventricle N. Engl. J. Med., May 6, 2004; 350(19): 1953 - 1959. [Abstract] [Full Text] [PDF]
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F. A. McAlister, J. Ezekowitz, M. Tonelli, and P. W. Armstrong Renal Insufficiency and Heart Failure: Prognostic and Therapeutic Implications From a Prospective Cohort Study Circulation, March 2, 2004; 109(8): 1004 - 1009. [Abstract] [Full Text] [PDF]
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M. Tendera The epidemiology of heart failure Journal of Renin-Angiotensin-Aldosterone System, March 1, 2004; 5(1_suppl): S2 - S6. [Abstract] [PDF]
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M. Schaufelberger, K. Swedberg, M. Koster, M. Rosen, and A. Rosengren Decreasing one-year mortality and hospitalization rates for heart failure in Sweden: Data from the Swedish Hospital Discharge Registry 1988 to 2000 Eur. Heart J., February 2, 2004; 25(4): 300 - 307. [Abstract] [Full Text] [PDF]
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G. W. Dorn II and J. D. Molkentin Manipulating Cardiac Contractility in Heart Failure: Data From Mice and Men Circulation, January 20, 2004; 109(2): 150 - 158. [Full Text] [PDF]
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