risk factors

Last edited 03/2021 and last reviewed 09/2021

Many different conditions may predispose to heart failure:

  • acute heart failure:
    • ischemic heart disease - acute coronary syndromes, mechanical complications of acute MI
    • valvular - stenosis, regurgitation, endocarditis
    • hypertension/arrhythmia
    • circulatory failure - septicaemia, thyrotoxicosis, pulmonary embolism
    • decompensation of pre-existing chronic HF - cerebrovascular insults, infections
  • chronic heart failure:
    • conditions that damage heart muscle or limit its ability to function normally:
      • coronary artery disease - commonest
      • hypertension - next most common cause
      • cardiomyopthy
      • drugs – beta blockers, calcium antagonists, antiarrhythmics, cytotoxic agents
      • toxins - alcohol, drugs, cocaine, mercury, cobalt, arsenic
      • endocrine - diabetes, hypo/hyperthyroidism, Cushing's syndrome
      • infiltrative conditions – sarcoidosis, amyloidosis
      • other conditions – Chagas’ disease, HIV infection
    • HF secondary to high cardiac output conditions
      • anaemia
      • thyrotoxicosis
      • septicaemia
      • liver failure
      • arteriovenous shunts (1)

Notes (2):

  • hypertension, diabetes, smoking history, and previous myocardial infarction conferred a greater relative risk of heart failure in younger than in older people

  • risk factors had greater discriminatory value in predicting new onset of heart failure in younger than in older people

  • a greater proportion of the overall population attributable risk was explained by diabetes, smoking history, and previous myocardial infarction in younger than in older people

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