Diabetes triples the likelihood that postmenopausal women with coronary heart disease will develop heart failure.
"For many years, clinicians and researchers thought of heart failure as a disease of men," lead author Dr. Kirsten Bibbins-Domingo, from San Francisco General Hospital, stated. "But recent studies indicate that women get heart failure to the same extent as men. The lifetime risk in both sexes is 1 in 5."
Nevertheless, "not much was known about what predisposes women to heart failure, except that they seemed less likely to have a preceding heart attack than men," she added.
To better understand the risk factors for heart failure in women with coronary disease, the researchers analyzed data from 2391 postmenopausal women who were followed for an average of 6.3 years.
The nine predictor of heart failure were diabetes, atrial fibrillation, heart attack, impaired kidney function, high blood pressure, current smoking, obesity, conduction disturbances and left-sided heart enlargement.
The presence of diabetes tripled the risk of heart failure, the investigators report in the American Heart Association’s journal Circulation.
In women who were also obese, the annual rate of heart failure was 8 percent. In diabetic women with kidney impairment, it was 13 percent.
"Many of the risk factors we uncovered are, of course, the same ones seen in men," Bibbins-Domingo continued. "But what was particularly striking was the risk seen with diabetes. In our analysis, it was a stronger risk factor than having multiple heart attacks" – probably the strongest predictor in men. Many of the identified risks are modifiable, she concluded.
Circulation, September 7th online issue, 2004.