Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan.
Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.
ESC Heart Fail. 2023 Feb;10(1):90-99. doi: 10.1002/ehf2.14149. Epub 2022 Sep 24.
Evidence on the risk factors for incident heart failure in Asia has been limited. We sought to identify the risk factors for pre-heart failure or symptomatic heart failure, based on N-terminal pro-B-type natriuretic peptide (NT-proBNP), in the Japanese general population.
We performed a retrospective cohort study based on the Circulatory Risk in Communities Study involving 5335 Japanese individuals whose NT-proBNP levels were measured between 2010 and 2015. Of these, 2768 people aged between 30 and 69 years who undertook annual cardiovascular risk surveys at least once between 1990 and 2000 were retrospectively eligible to be participants in this study. We performed multivariable logistic regression analyses to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of pre-heart failure or symptomatic heart failure defined as NT-proBNP >400 pg/mL or as having a diagnosis of heart failure and taking medication for heart failure for several cardiovascular risk factors (body mass index, blood pressure, diabetes mellitus, total cholesterol, triglyceride, smoking status, drinking status).
We identified 85 cases of heart failure. The multivariable ORs (95% CIs) were 5.70 (2.70-12.0) for body mass index of 27-29.9 kg/m and 5.91 (2.19-16.0) for ≥30 kg/m compared with 21-22.9 kg/m ; 2.49(1.01-6.13) for systolic blood pressure of ≥160 mmHg vs. <130 mmHg; 2.87(1.23-6.68) for diastolic blood pressure of ≥100 mmHg vs. <80 mmHg; 5.16(2.14-12.4) for diabetes vs. non-diabetes; and 2.24 (0.92-5.49) for current smokers of ≥20 cigarettes/day vs. never smokers. The multivariable ORs (95% CIs) of the number of risk factors, defined as the sum of four risk factors (obesity, hypertension, diabetes, and current smoker) was 6.80 (3.69-12.5) for ≥2 risk factors vs. no risk factors.
The accumulation of these risk factors was associated with a graded higher risk of pre-heart failure or symptomatic heart failure.
亚洲心力衰竭事件风险因素的相关证据有限。我们试图基于 N 末端脑钠肽前体（NT-proBNP），确定日本普通人群中心力衰竭前期或有症状心力衰竭的风险因素。
我们进行了一项基于社区循环风险研究的回顾性队列研究，纳入了 5335 名在 2010 年至 2015 年间测量 NT-proBNP 水平的日本个体。其中，2768 名年龄在 30 至 69 岁之间的个体在 1990 年至 2000 年期间至少进行过一次年度心血管风险调查，符合该研究的回溯性入选标准。我们进行了多变量逻辑回归分析，以计算心力衰竭前期或有症状心力衰竭的比值比（OR）和 95%置信区间（CI），心力衰竭前期或有症状心力衰竭的定义为 NT-proBNP＞400pg/mL 或具有心力衰竭诊断并正在服用心力衰竭药物的患者。
我们确定了 85 例心力衰竭患者。多变量 OR（95%CI）为体质指数 27-29.9kg/m2 与 21-22.9kg/m2 相比为 5.70（2.70-12.0），≥30kg/m2 与 21-22.9kg/m2 相比为 5.91（2.19-16.0）；收缩压≥160mmHg 与＜130mmHg 相比为 2.49（1.01-6.13）；舒张压≥100mmHg 与＜80mmHg 相比为 2.87（1.23-6.68）；糖尿病与非糖尿病相比为 5.16（2.14-12.4）；每日吸烟≥20 支与从不吸烟者相比为 2.24（0.92-5.49）。定义为 4 种风险因素（肥胖、高血压、糖尿病和当前吸烟者）之和的风险因素数量的多变量 OR（95%CI）为≥2 个风险因素与无风险因素相比为 6.80（3.69-12.5）。
这些风险因素的累积与心力衰竭前期或有症状心力衰竭的风险呈梯度升高相关。
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