Heart failure doesn't discriminate

"This is a bad news scenario for both race groups," said Northwestern Medicine researcher Mark Huffman, M.D., the first author of the study. "With lifetime risks this high, heart failure prevention is paramount for all Americans."

Huffman is an assistant professor in preventive medicine and medicine-cardiology at Northwestern University Feinberg School of Medicine and a cardiologist at Northwestern Memorial Hospital.

The study is one of the first to explore the long-term risk of heart failure in different race groups. It was published online, April 1, in the Journal of the American College of Cardiology.

The higher level of risk for whites came somewhat as a surprise because previous studies, of predominantly white cohorts in Europe, had estimated lifetime risk for developing heart failure from 20 to 30 percent.

But the researchers were not overly surprised to find that black men who participated in these studies have a relatively lower lifetime risk for heart failure, 20 to 29 percent, compared to white men and black and white women.

"Heart failure is a disease of the aging, and on average, black men in America tend to have higher competing risks for death earlier in life," Huffman said. "Because competing risks are higher, which is itself a major problem, relatively fewer black men have the opportunity to develop heart failure compared to white men in these studies, because they die sooner of other causes."

This study is part of the ongoing Cardiovascular Lifetime Risk Pooling Project, led by principal investigator Donald Lloyd-Jones, M.D., chair and professor of preventive medicine and medicine-cardiology at Northwestern University Feinberg School of Medicine and a cardiologist at Northwestern Memorial Hospital.

Researchers used data from 39,000 participants in National Heart, Lung and Blood Institute-sponsored cohorts to estimate lifetime risks for developing heart failure at age 45 through 95. They also explored the relationships between lifetime heart failure risk and risk factors such as obesity, blood pressure and prior heart attack.

Some other key findings from the study:

• Whites and blacks with higher blood pressure and higher body mass index had a higher lifetime risk for heart failure.
• White males have the highest lifetime risk for heart failure, 30 to 42 percent
• Lifetime heart failure risk for black and white women is similar, 32 to 39 percent in white women, 24 to 46 percent in black women.

The good news: the majority of heart failure incidents are preventable.

"There are things we can do to help prevent heart failure risks, but it requires a concerted effort, not just on the individual level but in our communities," Lloyd-Jones said. "Not smoking, staying physically active, maintaining a healthy weight over a long period of time, maintaining a healthy blood pressure and preventing heart attacks are all things Americans can to keep their hearts healthy as they age."