15 million U.S. adults are at elevated risk for heart failure

Embargoed for release until 5:00 p.m. ET on Monday 16 December 2024    

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.         
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1. 15 million U.S. adults are at elevated risk for heart failure

New risk calculators identify an additional 4 million adults at increased risk for heart failure but lower risk for other heart disease, most of whom are older adults.

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-01321 

URL goes live when the embargo lifts         

A cross-sectional study used the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations to understand population-wide risk for heart failure (HF) and related variables. The results suggest that 15 million adults have an elevated risk for HF of which 4.3 million were not identified as having high risk for other heart disease. The study is published in Annals of Internal Medicine. 

Researchers from the University of Pittsburgh and colleagues studied data of 4,872 adults aged 30 to 79 years without known cardiovascular disease (CVD) who participated in the combined 2017 to March 2020 cycle of the National Health and Nutrition Examination Survey (NHANES). The researchers used the American Heart Association’s PREVENT equations to estimate HF and atherosclerotic cardiovascular disease (ASCVD) risk over a 10-year period for a study population representing 143.2 million Americans. They found that the average estimated 10-year risk for HF was 3.7%, with 15 million adults having a 10-year risk for HF above 10%. Most patients with a high risk of HF also had a high risk of ASCVD, but an estimated 4.3 million Americans with low ASCVD risk had high HF risk. Of those at elevated risk for HF, 62% were aged 70 to 79 and 14% were Black adults. Over half of participants with elevated HF risk had elevated blood pressure and over half were overweight or obese. These results indicate that the most important interventions to reduce HF risk are hypertension control and weight loss. The researchers suggest that future studies should focus on primary prevention of HF in people at high risk, including identifying screening protocols for HF and identifying risk reduction strategies. 

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author Timothy S. Anderson, MD, please email Elaine Vitone at vitoneeg@upmc.edu.

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2. Study exposes critical need for more research on health disparities in treatment of chronic conditions

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-01262

URL goes live when the embargo lifts          

A review of U.S.-based studies of interventions targeting racial and ethnic disparities in adults with chronic conditions found that few studies evaluated the effectiveness of such interventions in reducing gaps in health disparities. The researchers suggest there is a critical need for targeted, long-term research focused on underrepresented racial and ethnic groups to effectively address health disparities. This study is published in Annals of Internal Medicine.

Researchers from the University of Minnesota studied data from 174 unique studies of interventions targeting racial and ethnic disparities in adults with chronic conditions published between 2017 to 2024 to create an evidence map. The researchers aimed to identify interventions that have been studied and highlight gaps in knowledge and research needs. The studies included in the evidence map met certain eligibility criteria, including specifically aiming to examine the potential reduction of a disparity; aiming to improve outcomes for specified racially/ethnically minoritized people; and taking place in a health care setting or showing strong links between a health care organization and community-based settings. The results found that the largest category of interventions studied was self-management followed by patient navigation and prevention/lifestyle support. 57% of these studies included interventions that solely targeted patients. Only 3% of studies reported on equity of service between racially/ethnically minoritized people and other groups. Studies primarily occurred in clinical settings, however, some studies occurred in community-based settings, like churches or libraries, where health care is more likely to reach certain populations who are disconnected from traditional clinical settings. 46% of studies examined multiple racial groups including African Americans/Blacks, Hispanics/Latinos and Asians, but only 1% of studies targeted American Indian/Alaska Native populations. Cancer, diabetes and hypertension are the most researched chronic conditions, however, other conditions like mental health, liver disease and COPD that disproportionately affect racial and ethnic minority populations were underrepresented in the studies. The interventions studied for specific conditions were varied, with self-management more frequently targeted towards diabetes and patient navigation interventions primarily focused on cancer. The researchers hope that the evidence map created from this review of studies will inform health care system leaders, policymakers, researchers and funding bodies about the current state of intervention strategies, gaps in knowledge, and areas requiring further investigation in the treatment of chronic conditions among underrepresented racial and ethnic populations.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author Toyin Lamina, Ph.D., MPH, please email Rachel Smith at rachels@umn.edu.

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