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
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(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
Related Article:
Circulation 2002 106: 2997-2998.
This article has been cited by other articles:
 |
|
 |
|
  J. Butler, A. Kalogeropoulos, V. Georgiopoulou, R. Belue, N. Rodondi, M. Garcia, D. C. Bauer, S. Satterfield, A. L. Smith, V. Vaccarino, et al. Incident Heart Failure Prediction in the Elderly: The Health ABC Heart Failure Score Circ Heart Fail, July 1, 2008; 1(2): 125 - 133. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J Epstein Efficacy and Safety of Darusentan: A Novel Endothelin Receptor Antagonist Ann. Pharmacother., July 1, 2008; 42(7): 1060 - 1069. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Garcia-Touchard, V. K. Somers, L. J. Olson, and S. M. Caples Central Sleep Apnea: Implications for Congestive Heart Failure Chest, June 1, 2008; 133(6): 1495 - 1504. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Schocken, E. J. Benjamin, G. C. Fonarow, H. M. Krumholz, D. Levy, G. A. Mensah, J. Narula, E. S. Shor, J. B. Young, and Y. Hong Prevention of Heart Failure: A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group Circulation, May 13, 2008; 117(19): 2544 - 2565. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. S. Anand, T. S. Rector, M. Kuskowski, S. Thomas, N.J. Holwerda, and J. N. Cohn Effect of Baseline and Changes in Systolic Blood Pressure Over Time on the Effectiveness of Valsartan in the Valsartan Heart Failure Trial Circ Heart Fail, May 1, 2008; 1(1): 34 - 42. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. O. Ventura and M. Reddy The eye as an indicator of heart failure in diabetic patients. J. Am. Coll. Cardiol., April 22, 2008; 51(16): 1579 - 1580. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Torabi, J. G.F. Cleland, N. K. Khan, P. H. Loh, A. L. Clark, F. Alamgir, J. L. Caplin, A. S. Rigby, and K. Goode The timing of development and subsequent clinical course of heart failure after a myocardial infarction Eur. Heart J., April 1, 2008; 29(7): 859 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Konhilas What makes a dead cell attractive? J Appl Physiol, March 1, 2008; 104(3): 573 - 574. [Full Text] [PDF]
|
|
|
|
|
|
W. Rosamond, K. Flegal, K. Furie, A. Go, K. Greenlund, N. Haase, S. M. Hailpern, M. Ho, V. Howard, B. Kissela, et al. Heart Disease and Stroke Statistics--2008 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, January 29, 2008; 117(4): e25 - e146. [Full Text] [PDF]
|
|
|
|
|
|
R. M. Witteles and M. B. Fowler Insulin-Resistant Cardiomyopathy: Clinical Evidence, Mechanisms, and Treatment Options J. Am. Coll. Cardiol., January 15, 2008; 51(2): 93 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Muller, A. Kazakov, A. Semenov, M. Bohm, and U. Laufs Pressure-induced cardiac overload induces upregulation of endothelial and myocardial progenitor cells Cardiovasc Res, January 1, 2008; 77(1): 151 - 159. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Thune, J. Signorovitch, L. Kober, E. J. Velazquez, J. J.V. McMurray, R. M. Califf, A. P. Maggioni, J. L. Rouleau, J. Howlett, S. Zelenkofske, et al. Effect of Antecedent Hypertension and Follow-Up Blood Pressure on Outcomes After High-Risk Myocardial Infarction Hypertension, January 1, 2008; 51(1): 48 - 54. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Lee, J. M. Massaro, T. J. Wang, W. B. Kannel, E. J. Benjamin, S. Kenchaiah, D. Levy, R. B. D'Agostino Sr, and R. S. Vasan Antecedent Blood Pressure, Body Mass Index, and the Risk of Incident Heart Failure in Later Life Hypertension, November 1, 2007; 50(5): 869 - 876. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Djousse and J. M. Gaziano Breakfast Cereals and Risk of Heart Failure in the Physicians' Health Study I Arch Intern Med, October 22, 2007; 167(19): 2080 - 2085. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Okin, R. B. Devereux, K. E. Harris, S. Jern, S. E. Kjeldsen, S. Julius, J. M. Edelman, B. Dahlof, and for the LIFE Study Investigators Regression of Electrocardiographic Left Ventricular Hypertrophy Is Associated with Less Hospitalization for Heart Failure in Hypertensive Patients Ann Intern Med, September 4, 2007; 147(5): 311 - 319. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Atallah, J.-B. Durand, H. Kantarjian, and J. Cortes Congestive heart failure is a rare event in patients receiving imatinib therapy Blood, August 15, 2007; 110(4): 1233 - 1237. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Oka, J. Xu, R. A. Kaiser, J. Melendez, M. Hambleton, M. A. Sargent, A. Lorts, E. W. Brunskill, G. W. Dorn II, S. J. Conway, et al. Genetic Manipulation of Periostin Expression Reveals a Role in Cardiac Hypertrophy and Ventricular Remodeling Circ. Res., August 3, 2007; 101(3): 313 - 321. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. N. Kirkpatrick, M. A. Vannan, J. Narula, and R. M. Lang Echocardiography in Heart Failure: Applications, Utility, and New Horizons J. Am. Coll. Cardiol., July 31, 2007; 50(5): 381 - 396. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Ingelsson, J. Sundstrom, L. Lind, U. Riserus, A. Larsson, S. Basu, and J. Arnlov Low-grade albuminuria and the incidence of heart failure in a community-based cohort of elderly men Eur. Heart J., July 2, 2007; 28(14): 1739 - 1745. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Cronquist Christensen and D. Remler Information and Communications Technology in Chronic Disease Care: What Are the Implications for Payment? Med Care Res Rev, April 1, 2007; 64(2): 123 - 147. [Abstract] [PDF]
|
|
|
|
|
|
W. Rosamond, K. Flegal, G. Friday, K. Furie, A. Go, K. Greenlund, N. Haase, M. Ho, V. Howard, B. Kissela, et al. Heart Disease and Stroke Statistics--2007 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, February 6, 2007; 115(5): e69 - e171. [Full Text] [PDF]
|
|
|
|
|
|
L. Djousse and J. M. Gaziano Alcohol Consumption and Risk of Heart Failure in the Physicians' Health Study I Circulation, January 2, 2007; 115(1): 34 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. E. Merten, Y. Jiang, W. Feng, and Y. J. Kang Calcineurin Activation Is Not Necessary for Doxorubicin-Induced Hypertrophy in H9c2 Embryonic Rat Cardiac Cells: Involvement of the Phosphoinositide 3-Kinase-Akt Pathway J. Pharmacol. Exp. Ther., November 1, 2006; 319(2): 934 - 940. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. R. van Kimmenade, J. L. Januzzi Jr, P. T. Ellinor, U. C. Sharma, J. A. Bakker, A. F. Low, A. Martinez, H. J. Crijns, C. A. MacRae, P. P. Menheere, et al. Utility of Amino-Terminal Pro-Brain Natriuretic Peptide, Galectin-3, and Apelin for the Evaluation of Patients With Acute Heart Failure J. Am. Coll. Cardiol., September 19, 2006; 48(6): 1217 - 1224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Gheorghiade, G. Sopko, L. De Luca, E. J. Velazquez, J. D. Parker, P. F. Binkley, Z. Sadowski, K. S. Golba, D. L. Prior, J. L. Rouleau, et al. Navigating the Crossroads of Coronary Artery Disease and Heart Failure Circulation, September 12, 2006; 114(11): 1202 - 1213. [Full Text] [PDF]
|
|
|
|
|
|
C. L. Bryson, K. J. Mukamal, M. A. Mittleman, L. P. Fried, C. H. Hirsch, D. W. Kitzman, and D. S. Siscovick The Association of Alcohol Consumption and Incident Heart Failure: The Cardiovascular Health Study J. Am. Coll. Cardiol., July 18, 2006; 48(2): 305 - 311. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Lopez, A. Gonzalez, R. Querejeta, M. Larman, and J. Diez Alterations in the Pattern of Collagen Deposition May Contribute to the Deterioration of Systolic Function in Hypertensive Patients With Heart Failure J. Am. Coll. Cardiol., July 4, 2006; 48(1): 89 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Nishikawa, M. Yoshida, M. Kusuhara, N. Ishigami, K. Isoda, K. Miyazaki, and F. Ohsuzu Left ventricular hypertrophy in mice with a cardiac-specific overexpression of interleukin-1 Am J Physiol Heart Circ Physiol, July 1, 2006; 291(1): H176 - H183. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Battaglia, D. Pewsner, P. Juni, M. Egger, H. C. Bucher, and L. M. Bachmann Accuracy of B-type natriuretic Peptide tests to exclude congestive heart failure: systematic review of test accuracy studies. Arch Intern Med, May 22, 2006; 166(10): 1073 - 1080. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Ahmed, L. L. Clark, W. R. Pennington, C. S. Webb, D. D. Bonnema, A. H. Leonardi, C. D. McClure, F. G. Spinale, and M. R. Zile Matrix Metalloproteinases/Tissue Inhibitors of Metalloproteinases: Relationship Between Changes in Proteolytic Determinants of Matrix Composition and Structural, Functional, and Clinical Manifestations of Hypertensive Heart Disease Circulation, May 2, 2006; 113(17): 2089 - 2096. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. P. B.-L. Rocca, J. Capraro, and W. Kiowski Compliance by Referring Physicians With Recommendations on Heart Failure Therapy from a Tertiary Center Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2006; 11(1): 85 - 92. [Abstract] [PDF]
|
|
|
|
 |
|
 R. E. Gilbert, K. Connelly, D. J. Kelly, C. A. Pollock, and H. Krum Heart Failure and Nephropathy: Catastrophic and Interrelated Complications of Diabetes Clin. J. Am. Soc. Nephrol., March 1, 2006; 1(2): 193 - 208. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Xu, T. R. Kimball, J. N. Lorenz, D. A. Brown, A. R. Bauskin, R. Klevitsky, T. E. Hewett, S. N. Breit, and J. D. Molkentin GDF15/MIC-1 Functions As a Protective and Antihypertrophic Factor Released From the Myocardium in Association With SMAD Protein Activation Circ. Res., February 17, 2006; 98(3): 342 - 350. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Thom, N. Haase, W. Rosamond, V. J. Howard, J. Rumsfeld, T. Manolio, Z.-J. Zheng, K. Flegal, C. O'Donnell, S. Kittner, et al. Heart Disease and Stroke Statistics--2006 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, February 14, 2006; 113(6): e85 - e151. [Full Text] [PDF]
|
|
|
|
|
|
D. M. Lloyd-Jones, E. P. Leip, M. G. Larson, R. B. D'Agostino, A. Beiser, P. W.F. Wilson, P. A. Wolf, and D. Levy Prediction of Lifetime Risk for Cardiovascular Disease by Risk Factor Burden at 50 Years of Age Circulation, February 14, 2006; 113(6): 791 - 798. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. S. Aronow Drug Treatment of Systolic and of Diastolic Heart Failure in Elderly Persons J. Gerontol. A Biol. Sci. Med. Sci., December 1, 2005; 60(12): 1597 - 1605. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 C. Nielson and T. Lange Blood Glucose and Heart Failure in Nondiabetic Patients Diabetes Care, March 1, 2005; 28(3): 607 - 611. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 A. Sanbe, H. Osinska, J. E. Saffitz, C. G. Glabe, R. Kayed, A. Maloyan, and J. Robbins Desmin-related cardiomyopathy in transgenic mice: A cardiac amyloidosis PNAS, July 6, 2004; 101(27): 10132 - 10136. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
B. J. Wilkins, Y.-S. Dai, O. F. Bueno, S. A. Parsons, J. Xu, D. M. Plank, F. Jones, T. R. Kimball, and J. D. Molkentin Calcineurin/NFAT Coupling Participates in Pathological, but not Physiological, Cardiac Hypertrophy Circ. Res., January 9, 2004; 94(1): 110 - 118. [Abstract] [Full Text] [PDF]
|
|