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(Circulation. 2002;106:2997.)
© 2002 American Heart Association, Inc.

Editorial

A Lifetime of Prevention

The Case of Heart Failure

Salim Yusuf, DPhil, FRCPC; Bertram Pitt, MD

From McMaster University (S.Y.), Hamilton, Ontario, Canada, and the University of Michigan, Ann Arbor (B.P.).

Correspondence to Dr Salim Yusuf, DPhil, FRCPC, Population Health Research Institute, 2nd Floor, McMaster Clinic, Rm 252, 237 Barton St East, Hamilton, Ontario, Canada L8L 2X2. E-mail yusufs@mcmaster.ca

Key Words: Editorials • heart failure • prevention • risk factors

An extract of the first 250 words of the full text is provided, because this article has no abstract.

It is widely acknowledged that heart failure (HF) is a growing public health and clinical problem and that, once diagnosed, the prognosis is grim. In this issue of Circulation, Lloyd-Jones and colleagues¹ provide a lifetime perspective of HF from the Framingham Heart Study. Several messages are notable. First, the lifetime risk of developing HF at all ages is 20 percent in both men and women. This contrasts with the fact that short-term risks are substantially lower in younger individuals compared with older individuals (eg, 0.5% 5-year risk versus 21.0% lifelong risk, or a 40-fold difference in those 40 years of age; 1% versus 20%, or a 20-fold difference in those 60 years of age; and 8% versus 20%, or a 2.5-fold difference in those 80 years of age). This implies that for preventive strategies to be fully effective against HF, they may have to be implemented throughout the lifetime of an individual.

See p 3068

Second, the analysis by Lloyd-Jones et al confirms the importance of hypertension and myocardial infarction, which together account for about three quarters of the population-attributable risk of HF. Both myocardial infarction² and hypertension³ are largely preventable with currently known and available strategies (Table). The importance of hypertension is exemplified by the 2-fold increase in risk of HF among those with systolic blood pressure (BP) >160 and diastolic BP >90 mm Hg compared with those with both systolic BP <140 and diastolic BP <90. This risk is likely to be continuous so that . . . [Full Text of this Article]

Related Article:

Lifetime Risk for Developing Congestive Heart Failure: The Framingham Heart Study

Donald M. Lloyd-Jones, Martin G. Larson, Eric P. Leip, Alexa Beiser, Ralph B. D’Agostino, William B. Kannel, Joanne M. Murabito, Ramachandran S. Vasan, Emelia J. Benjamin, and Daniel Levy
Circulation 2002 106: 3068-3072. [Abstract] [Full Text]

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