Sex differences in the association of risk factors for heart failure incidence and mortality

Sillars, A., Ho, F. K., Pell, J. P. , Gill, J. M.R. , Sattar, N. , Gray, S. and Celis-Morales, C. (2020) Sex differences in the association of risk factors for heart failure incidence and mortality. Heart, 106(3), pp. 203-212. (doi: 10.1136/heartjnl-2019-314878) (PMID:31366573)

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Abstract

Background: There are known risk factors associated with the development of heart failure (HF), but it is not fully understood whether these differ by sex. Objectives: To investigate sex differences in risk factors for HF incidence and mortality. Methods: 468 941 participants (55.9% women, age range 37–73 years) were included. Established CVD risk factors (hypertension, hypercholesterolaemia, diabetes type 1 and 2, adiposity, smoking, physical activity and poor diet) and novel risk factors (grip strength, fitness, TV viewing and sleep duration) were the exposures of interest. HF incidence and mortality were the outcomes. Results: Over a mean follow-up of 9.0 years, 1812 participants developed HF and 763 died due to HF. Women with type 1 diabetes (T1DM), type 2 diabetes (T2DM), hypertension, hypercholesterolaemia, low levels of physical activity and fitness, low strength, high levels of TV viewing, sleep duration <7 hours/day, smokers; those who were underweight and who were obese, had high body surface area and those who drink >14 units of alcohol were at higher risk of HF incidence. However, in women T2DM, hypercholesterolaemia, >3 hours/day of TV and sleep <7 hours/day, low level of physical activity and high level of TV viewing were more strongly associated with HF incidence compared with men. Conclusion: Several modifiable risk factors (in particular diabetes) appear more strongly associated with HF in women compared with men. The relevance of these findings to HF characteristics and future outcomes needs to be established.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Celis, Dr Carlos and Pell, Professor Jill and Gray, Dr Stuart and Gill, Professor Jason and Ho, Dr Frederick and Sillars, Dr Anne and Sattar, Professor Naveed
Authors: Sillars, A., Ho, F. K., Pell, J. P., Gill, J. M.R., Sattar, N., Gray, S., and Celis-Morales, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:Heart
Publisher:BMJ Publishing Group
ISSN:1355-6037
ISSN (Online):1468-201X
Published Online:31 July 2019
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in Heart 106(3):203-212
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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