In a European population-based cohort study, the lifetime risk of incident HFrEF was higher in men, while women were at greater risk of developing HFpEF

In a European population-based cohort study, the lifetime risk of incident HFrEF was higher in men, while women were at greater risk of developing HFpEF. Moreover, 8 modifiable risk factors substantially contributed to these risks, particularly in women.

ESC Educational team. Date: March 6, 2025

Key Findings:

1. Overall Lifetime Risk of Heart Failure (HF):

• Men: 24.5%

• Women: 23.3%

2. Lifetime Risk of Heart Failure with Reduced Ejection Fraction (HFrEF):

• Men: 18.1%

• Women: 11.9%

3. Lifetime Risk of Heart Failure with Preserved Ejection Fraction (HFpEF):

• Men: 6.4%

• Women: 11.5%

4. Contributing Modifiable Risk Factors:

• Eight risk factors were analyzed: hypertension, hypercholesterolemia, obesity, smoking, atrial fibrillation, chronic kidney disease, myocardial infarction, and diabetes mellitus.

5. Cumulative Population Attributable Fraction (PAF) for HFrEF:

• Men: 60%

• Women: 71%

6. Cumulative PAF for HFpEF:

• Men: 46%

• Women: 64%

7. Strongest Risk Factors for HFrEF:

• Men: Hypertension (23%), hypercholesterolemia (20%), myocardial infarction (18%), smoking (16%), obesity (10%)

• Women: Hypertension (39%), hypercholesterolemia (28%), smoking (19%)

8. Strongest Risk Factors for HFpEF:

• Men: Hypertension (30%), obesity (16%), diabetes (10%)

• Women: Hypertension (46%), obesity (20%), smoking (12%)

These findings highlight the importance of proactive screening and management of modifiable risk factors, especially in women, to reduce the incidence of heart failure.