Diabetes over long duration associated with heart failure risk: Study
USA: The longer is the diabetes duration higher is the risk for developing heart failure (HF), a recent study has revealed. The association was found to be stronger among women, those younger than 65, Black people, those with higher body mass index, and those with A1C of 7% or higher. Further, the study showed that people who had diabetes or prediabetes had a higher risk of heart failure versus those who didn't have the conditions.
The study, published in the journal JACC: Heart Failure, analyzed nearly 10,000 U.S. adults and followed them for a median of about 23 years.
Previous studies have shown diabetes to be a risk factor for heart failure. However, not much is known about the independent effect of diabetes duration on incident HF. Justin B. Echouffo-Tcheugui, Johns Hopkins University, Baltimore, Maryland, USA, and colleagues, therefore, aimed to assess the association of diabetes duration with incident heart failure.
For this purpose, the researchers included 9,734 participants (mean age 63 years, 58% women, 22% Black) at ARIC (Atherosclerosis Risk In Communities) Visit 4 (1996-1998) without HF or coronary heart disease. Diabetes duration was calculated at Visit 4 (baseline), utilizing diabetes status at the first 4 ARIC visits spaced 3 years apart, and self-reported diagnosis date for those with diabetes diagnosed before Visit 1.
Cox regression was used to estimate associations of diabetes duration with incident HF, accounting for intercurrent coronary heart disease and other risk factors. The researchers performed analyses stratified by age (<65 years or ≥65 years), race, sex, and glycemic control (hemoglobin A1C [HbA1C] consistently <7%, vs HbA1C ≥7%), with tests for interaction.
On analysis, the researchers found the following:
- Over 22.5 years of follow-up, there were 1,968 HF events.
- Compared to those without diabetes, HF risk rose with longer diabetes duration, with the highest risk among those with ≥15 y diabetes duration (HR: 2.82).
- Each 5-year increase in diabetes duration was associated with a 17% relative increase in HF risk. Similar results were observed across HF subtypes.
- The HF and diabetes duration associations were stronger among those aged <65 years, those with HbA1C ≥7%, those with a body mass index ≥30 kg/m2, women, and Blacks.
"Our findings showed that delaying diabetes onset may augment HF prevention efforts, and therapies to improve HF outcomes might target those with long diabetes duration," concluded the authors.
The study titled, "Duration of Diabetes and Incident Heart Failure: The ARIC (Atherosclerosis Risk In Communities) Study," is published in the journal JACC: Heart Failure.