Independent and Joint Associations of Obesity and Hypertension on Incident Heart Failure: A Pooled Cohort Analysis

IF 6.7 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings Pub Date : 2025-08-01 DOI:10.1016/j.mayocp.2025.01.025

Arsalan Hamid MD , Abdul Mannan Khan Minhas MD, MS , Affan M. Rizwan , Daisuke Kamimura MD, PhD , Maria Clarissa Tio MD, MS , Candace Howard Claudio MD, PhD , Ambarish Pandey MD, MS , Robert Mentz MD , Vijay Nambi MD, PhD , Daniel W. Jones MD , John E. Hall PhD , Javed Butler MD, MPH, MBA , Michael E. Hall MD, MS

{"title":"Independent and Joint Associations of Obesity and Hypertension on Incident Heart Failure: A Pooled Cohort Analysis","authors":"Arsalan Hamid MD , Abdul Mannan Khan Minhas MD, MS , Affan M. Rizwan , Daisuke Kamimura MD, PhD , Maria Clarissa Tio MD, MS , Candace Howard Claudio MD, PhD , Ambarish Pandey MD, MS , Robert Mentz MD , Vijay Nambi MD, PhD , Daniel W. Jones MD , John E. Hall PhD , Javed Butler MD, MPH, MBA , Michael E. Hall MD, MS","doi":"10.1016/j.mayocp.2025.01.025","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To assess the independent and combined associations of obesity and hypertension on incident heart failure (HF).</div></div><div><h3>Methods</h3><div>We studied participants of 3 epidemiologic cohorts: Atherosclerosis Risk in Communities (baseline visit 4, 1996-1998, to follow-up, 2017), Multi-Ethnic Study of Atherosclerosis (baseline examination 1, 2000-2002, to follow-up, 2015), and Jackson Heart Study (baseline visit 1, 2000-2004, to follow-up, 2014). Participants were stratified into 4 groups: neither obesity nor hypertension (reference), only obesity, only hypertension, or both. Hypertension was defined as systolic blood pressure of 140 mm Hg or higher, diastolic blood pressure of 90 mm Hg or higher, or use of antihypertensive medications at baseline. Obesity was defined as body mass index of 30 kg/m<sup>2</sup> or higher. Cox proportional hazards models adjusted for prespecified covariates were used to assess the association of the 4 groups with incident HF.</div></div><div><h3>Results</h3><div>Overall, 18,351 participants were included in the analyses. Participants with only obesity (adjusted hazard ratio [aHR], 1.60; 95% CI, 1.36 to 1.88) and only hypertension (aHR, 2.10; 95% CI, 1.87 to 2.37) demonstrated a higher risk of incident HF, whereas the highest risk of incident HF was in participants with both comorbidities (aHR, 2.97; 95% CI, 2.63 to 3.36) compared with participants with neither. Furthermore, participants with both obesity and hypertension had a higher risk of incident HF (aHR, 1.86; 95% CI, 1.60 to 2.16) compared with only obesity.</div></div><div><h3>Conclusion</h3><div>Obesity and hypertension are associated with incident HF, and individuals with both have the highest risk of HF. Hypertension increases the risk of incident HF in participants with obesity. These data highlight the impact of obesity and hypertension and how together they have a higher risk of HF.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 8","pages":"Pages 1297-1308"},"PeriodicalIF":6.7000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Mayo Clinic proceedings","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0025619625001090","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To assess the independent and combined associations of obesity and hypertension on incident heart failure (HF).

Methods

We studied participants of 3 epidemiologic cohorts: Atherosclerosis Risk in Communities (baseline visit 4, 1996-1998, to follow-up, 2017), Multi-Ethnic Study of Atherosclerosis (baseline examination 1, 2000-2002, to follow-up, 2015), and Jackson Heart Study (baseline visit 1, 2000-2004, to follow-up, 2014). Participants were stratified into 4 groups: neither obesity nor hypertension (reference), only obesity, only hypertension, or both. Hypertension was defined as systolic blood pressure of 140 mm Hg or higher, diastolic blood pressure of 90 mm Hg or higher, or use of antihypertensive medications at baseline. Obesity was defined as body mass index of 30 kg/m² or higher. Cox proportional hazards models adjusted for prespecified covariates were used to assess the association of the 4 groups with incident HF.

Results

Overall, 18,351 participants were included in the analyses. Participants with only obesity (adjusted hazard ratio [aHR], 1.60; 95% CI, 1.36 to 1.88) and only hypertension (aHR, 2.10; 95% CI, 1.87 to 2.37) demonstrated a higher risk of incident HF, whereas the highest risk of incident HF was in participants with both comorbidities (aHR, 2.97; 95% CI, 2.63 to 3.36) compared with participants with neither. Furthermore, participants with both obesity and hypertension had a higher risk of incident HF (aHR, 1.86; 95% CI, 1.60 to 2.16) compared with only obesity.

Conclusion

Obesity and hypertension are associated with incident HF, and individuals with both have the highest risk of HF. Hypertension increases the risk of incident HF in participants with obesity. These data highlight the impact of obesity and hypertension and how together they have a higher risk of HF.

查看原文本刊更多论文

肥胖和高血压与心力衰竭事件的独立和联合关联：一项汇总队列分析。

目的：评估肥胖和高血压与心力衰竭（HF）的独立和联合关系。方法：我们研究了3个流行病学队列的参与者：社区动脉粥样硬化风险（基线检查4,1996 -1998年至随访，2017年），动脉粥样硬化多种族研究（基线检查1,2000 -2002年至随访，2015年）和杰克逊心脏研究（基线检查1,2000 -2004年至随访，2014年）。参与者被分为4组：既不肥胖也不高血压（参考），只有肥胖，只有高血压，或两者兼而有之。高血压的定义是收缩压为140毫米汞柱或更高，舒张压为90毫米汞柱或更高，或在基线时使用抗高血压药物。肥胖定义为体重指数为30 kg/m2或更高。采用预先指定协变量调整的Cox比例风险模型来评估4组与心衰事件的关联。结果：总共有18351名参与者被纳入分析。仅肥胖的参与者(校正风险比[aHR]， 1.60；95% CI, 1.36 ~ 1.88)，仅高血压(aHR, 2.10；95% CI, 1.87 - 2.37)表明心衰发生率较高，而两种合并症患者的心衰发生率最高(aHR, 2.97；95% CI, 2.63 - 3.36)。此外，肥胖和高血压的参与者发生HF的风险更高(aHR, 1.86；95% CI, 1.60 - 2.16)与肥胖相比。结论：肥胖和高血压与心衰发生率相关，且两者的个体发生心衰的风险最高。高血压增加肥胖参与者发生心衰的风险。这些数据强调了肥胖和高血压的影响，以及它们如何共同增加心衰的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Mayo Clinic proceedings 医学-医学：内科

CiteScore

16.80

自引率

1.10%

发文量

383

审稿时长

37 days

期刊介绍： Mayo Clinic Proceedings is a premier peer-reviewed clinical journal in general medicine. Sponsored by Mayo Clinic, it is one of the most widely read and highly cited scientific publications for physicians. Since 1926, Mayo Clinic Proceedings has continuously published articles that focus on clinical medicine and support the professional and educational needs of its readers. The journal welcomes submissions from authors worldwide and includes Nobel-prize-winning research in its content. With an Impact Factor of 8.9, Mayo Clinic Proceedings is ranked #20 out of 167 journals in the Medicine, General and Internal category, placing it in the top 12% of these journals. It invites manuscripts on clinical and laboratory medicine, health care policy and economics, medical education and ethics, and related topics.