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The Association of Obesity and Cardiometabolic Traits With Incident HFpEF and HFrEF.
Wednesday,2018-09-19 12:29 America/Los_Angeles — ecterry
| Title | The Association of Obesity and Cardiometabolic Traits With Incident HFpEF and HFrEF. |
| Publication Type | Journal Article |
| Year of Publication | 2018 |
| Authors | Savji, N, Meijers, WC, Bartz, TM, Bhambhani, V, Cushman, M, Nayor, M, Kizer, JR, Sarma, A, Blaha, MJ, Gansevoort, RT, Gardin, JM, Hillege, HL, Ji, F, Kop, WJ, Lau, ES, Lee, DS, Sadreyev, R, van Gilst, WH, Wang, TJ, Zanni, MV, Vasan, RS, Allen, NB, Psaty, BM, van der Harst, P, Levy, D, Larson, M, Shah, SJ, de Boer, RA, Gottdiener, JS, Ho, JE |
| Journal | JACC Heart Fail |
| Volume | 6 |
| Issue | 8 |
| Pagination | 701-709 |
| Date Published | 2018 Aug |
| ISSN | 2213-1787 |
| Abstract | <p><b>OBJECTIVES: </b>This study evaluated the associations of obesity and cardiometabolic traits with incident heart failure with preserved versus reduced ejection fraction (HFpEF vs. HFrEF). Given known sex differences in HF subtype, we examined men and women separately.</p><p><b>BACKGROUND: </b>Recent studies suggest that obesity confers greater risk of HFpEF versus HFrEF. Contributions of associated metabolic traits to HFpEF are less clear.</p><p><b>METHODS: </b>We studied 22,681 participants from 4 community-based cohorts followed for incident HFpEF versus HFrEF (ejection fraction ≥50% vs. <50%). We evaluated the association of body mass index (BMI) and cardiometabolic traits with incident HF subtype using Cox models.</p><p><b>RESULTS: </b>The mean age was 60 ± 13 years, and 53% were women. Over a median follow-up of 12 years, 628 developed incident HFpEF and 835 HFrEF. Greater BMI portended higher risk of HFpEF compared with HFrEF (hazard ratio [HR]: 1.34 per 1-SD increase in BMI; 95% confidence interval [CI]: 1.24 to 1.45 vs. HR: 1.18; 95% CI: 1.10 to 1.27). Similarly, insulin resistance (homeostatic model assessment of insulin resistance) was associated with HFpEF (HR: 1.20 per 1-SD; 95% CI: 1.05 to 1.37), but not HFrEF (HR: 0.99; 95% CI: 0.88 to 1.11; p < 0.05 for difference HFpEF vs. HFrEF). We found that the differential association of BMI with HFpEF versus HFrEF was more pronounced among women (p for difference HFpEF vs. HFrEF = 0.01) when compared with men (p = 0.34).</p><p><b>CONCLUSIONS: </b>Obesity and related cardiometabolic traits including insulin resistance are more strongly associated with risk of future HFpEF versus HFrEF. The differential risk of HFpEF with obesity seems particularly pronounced among women and may underlie sex differences in HF subtypes.</p> |
| DOI | 10.1016/j.jchf.2018.05.018 |
| Alternate Journal | JACC Heart Fail |
| PubMed ID | 30007554 |
| PubMed Central ID | PMC6076337 |
| Grant List | N01 HC095166 / HC / WHI NIH HHS / United States HHSN268201500003C / HL / NHLBI NIH HHS / United States N01HC95160 / HL / NHLBI NIH HHS / United States R01 HL140224 / HL / NHLBI NIH HHS / United States N01 HC095167 / HC / NHLBI NIH HHS / United States N01HC95163 / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States HHSN268201500001C / HL / NHLBI NIH HHS / United States UL1 TR001079 / TR / NCATS NIH HHS / United States N01 HC095164 / HC / WHI NIH HHS / United States U01 HL130114 / HL / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States N01HC95169 / HL / NHLBI NIH HHS / United States N01 HC095160 / HC / WHI NIH HHS / United States N01HC95164 / HL / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC95162 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01HC95168 / HL / NHLBI NIH HHS / United States P30 DK063491 / DK / NIDDK NIH HHS / United States N01 HC095168 / HC / WHI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States N01HC95165 / HL / NHLBI NIH HHS / United States N01HC95159 / HL / NHLBI NIH HHS / United States HHSN268201500001I / HL / NHLBI NIH HHS / United States N01HC95161 / HL / NHLBI NIH HHS / United States N01 HC095169 / HC / NHLBI NIH HHS / United States UL1 TR001420 / TR / NCATS NIH HHS / United States N01 HC095165 / HC / WHI NIH HHS / United States N01 HC085079 / HC / WHI NIH HHS / United States N01 HC085081 / HC / WHI NIH HHS / United States N01 HC095161 / HC / WHI NIH HHS / United States K23 HL138260 / HL / NHLBI NIH HHS / United States HHSN268201500003I / HL / NHLBI NIH HHS / United States K23 HL116780 / HL / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01HC25195 / HL / NHLBI NIH HHS / United States UL1 TR000040 / TR / NCATS NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01HC95166 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States UL1 TR001881 / TR / NCATS NIH HHS / United States N01 HC095162 / HC / NHLBI NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States N01 HC095163 / HC / WHI NIH HHS / United States N01 HC095159 / HC / WHI NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States R01 HL134893 / HL / NHLBI NIH HHS / United States |
ePub date:
18/07