New research suggests that 15 million Americans have an elevated risk of heart failure

Report Says 15 Million Americans Face Increased Risk of Heart Failure—Here Are the Factors to Look Out For Here's what may put you at risk, and the steps you can take to prevent heart failure

New research suggests that 15 million Americans have an elevated risk of heart failure

• A new study suggests that 15 million Americans could have an increased risk of developing heart failure.
• Heart failure is a general term for when the heart cannot meet the body’s needs, diagnosed when the heart loses pumping power.
• People aged 70 to 79 and those with high blood pressure, obesity, and diabetes are most at risk of heart failure, the study found.

An estimated 15 million Americans may be at risk of developing heart failure, according to a new report.

The study, published on Dec. 17 in Annals of Internal Medicine, uses newly minted equations that, for the first time, allow scientists to better predict a person’s risk of developing the condition.

Heart failure occurs when the heart becomes weaker and is no longer able to meet the body’s needs. People with heart failure experience symptoms such as frequent fatigue, swelling and buildup of fluid in the legs, and shortness of breath. About 6.7 million Americans currently have the condition.

Until fairly recently, doctors didn’t have effective tools to assess how many Americans may go on to develop heart failure.

But in 2023, an American Heart Association advisory group published a paper outlining what they call the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations. These equations take race out of the calculation and incorporate various measures of kidney, social, and metabolic health to better estimate a person’s heart failure risk.

To put the new equations to use, the authors of the new report collected survey data from 4,872 participants between the ages of 30 and 79, representative of the American adult population. The participants were asked to provide information on their sex, age, systolic blood pressure, body mass index (BMI), blood pressure medication use, diabetes, smoking status, and glomerular filtration rate (which is used to determine kidney health).

After crunching the numbers, the researchers estimated that 15 million people have at least a 10% risk of developing heart failure over the next decade. They also ran a similar test, and determined that about 6.6 million Americans are at risk of developing atherosclerosis, or plaque build-up in the arteries.

What Puts Someone At Risk of Heart Failure?

Of those estimated to be at a higher risk of heart failure, 62% are between the ages of 70 and 79. This aligns with other existing data on heart failure.

“The patterns of people at risk for heart failure largely track with the same patterns seen in patients with heart failure,” study author Timothy Anderson, MD, assistant professor of medicine at the University of Pittsburgh, said in a press release. “Age is the biggest driver.”

This was in spite of the fact that older adults in the study were more likely to have risk factors for heart failure, including obesity and diabetes, under control.

“Most of the elderly people found to be at risk [of heart failure] don’t have any of these modifiable factors,” Francisco Lopez-Jimenez, MD, professor of medicine and consultant in the Division of Preventive Cardiology at the Mayo Clinic, told Health.

But beyond age, the researchers found that obesity and high blood pressure play a large role in heart failure risk, too. Just over 55% of people at an elevated risk had a BMI over 30 kg/m², and about 53% had systolic blood pressure (the top number on a reading) above 130 mm Hg.

Elevated hemoglobin A1c (HbA1c) levels—an indicator of diabetes—was another common risk factor for heart failure, particularly among Hispanic adults. Diabetes is more prevalent in Hispanic Americans, which could explain why it could play a larger role in the development of heart failure for this demographic, Lopez-Jimenez said.

“High blood pressure, elevated BMI, and high HbA1c reflect the adverse effects of hypertension, obesity, and uncontrolled diabetes on the heart,” Chiadi Ndumele, MD, PhD, director of obesity and cardiometabolic research and director of the Heart Failure Prevention Program at Johns Hopkins School of Medicine, told Health. “Each of these conditions cause deteriorations in the structure and function of the heart, which contribute to the risk for developing heart failure.”

Current smokers were also at a higher risk of heart failure, the report showed. This is because smoking damages the heart and blood vessels, and increases plaque build-up in the arteries—this can raise the chances of heart failure.

And though race wasn’t a factor in the PREVENT equations themselves, the data did show that Black Americans were overrepresented in the group of those at an elevated risk for heart failure.

“The authors found a somewhat higher prevalence of elevated risk factors among Black and Hispanic adults with elevated heart failure risk,” Ndumele said. “This is likely due to a higher burden of adverse social determinants of health among Black and Hispanic adults.”

There are a few other factors that could increase a person’s risk of heart failure, including coronary artery disease, heart attacks, other heart conditions, a sedentary lifestyle, or an unhealthy diet. Exposure to toxic drugs, family history, sleep apnea, and drinking too much alcohol might raise heart failure risk too, Ndumele added.

“However, these are not always readily identified in large population databases and are less commonly contributors to heart failure risk in the [general] population,” he said.

Preventing Heart Failure

Though this new report gives us better insight into just how widespread heart failure risk may be, there are a few limitations to keep in mind.

The underlying data used for this study is based on self-reported information rather than medical records, so there’s an opportunity for bias. Additionally, the researchers weren’t able to follow up on the risk scores and validate their accuracy, tracking who actually did develop heart failure over time. They also didn’t investigate the risk of different types of heart failure.

But even though more research is needed, the report’s heart failure predictions point to the importance of keeping modifiable risk factors—particularly obesity, diabetes, and high blood pressure—in check, experts agreed.

Hypertension, which affects nearly half of American adults, may be an especially good place to start. There’s some evidence that treating high blood pressure can reduce the risk of heart failure by 50%, Michele Hamilton, MD, professor of cardiology at Cedars-Sinai, told Health.

Often, people don’t feel very sick in the early stages of hypertension, she explained, so it can be easy to brush it under the rug. Familial support, better education, and easy access to medical care are crucial for making sure people follow through on interventions to improve their heart health, she said.

“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,” said Hamilton.

Julia is a news reporter and editor for Health, where she covers breaking and trending news on health and wellness topics. Her work has been featured in The Heights, an independent student newspaper at Boston College, and Minnesota Monthly.

This story originally appeared on: Health News - Author:Simon Spichak