Frailty alone and interactively with obesity predicts heart failure: Kuopio Ischaemic Heart Disease Risk Factor Study
Abstract Aims We aim to evaluate the association of frailty and high body mass index with risk of incident heart failure. Methods and results From the Kuopio Ischaemic Heart Disease Risk Factor Study, 408 women and 369 men, aged 61–74 years were included in this study. Frailty was ascertained with t...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-08-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.14392 |
| _version_ | 1827891573726117888 |
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| author | Behnam Tajik Ari Voutilainen Rajiv Sankaranarayanan Arja Lyytinen Jussi Kauhanen Gregory Y.H. Lip Tomi‐Pekka Tuomainen Masoud Isanejad |
| author_facet | Behnam Tajik Ari Voutilainen Rajiv Sankaranarayanan Arja Lyytinen Jussi Kauhanen Gregory Y.H. Lip Tomi‐Pekka Tuomainen Masoud Isanejad |
| author_sort | Behnam Tajik |
| collection | DOAJ |
| description | Abstract Aims We aim to evaluate the association of frailty and high body mass index with risk of incident heart failure. Methods and results From the Kuopio Ischaemic Heart Disease Risk Factor Study, 408 women and 369 men, aged 61–74 years were included in this study. Frailty was ascertained with the presence of 3–5 and prefrailty 1–2 of the following criteria: weight loss (highest 20% over 7 years), self‐reported tiredness, weakness (measured by handgrip strength), slow walking speed (walking pace), and low physical activity (lowest 20%). At the baseline, participants were allocated to frail (n = 36), prefrail (n = 340), and robust (n = 441). HF incidents were obtained by record linkages from the national hospitalization registry in Finland up to 31 December 2019. Multivariate Cox proportional hazards regression estimated the hazard ratio (HR) of incident events, adjusted for potential confounders. Two hundred one HF events were recorded (111 in women and 90 in men) during the 14.2 years follow‐up. After adjustment for the age and sex, the risk of HF events was higher among prefrail (HR 1.42, 95% CI 1.08 to 1.79, P = 0.02) and frail (HR 3.39, 95% CI 1.89 to 4.79, P ≤ 0.001) compared with the robust group. After adjusting for multiple confounders result remained significant for HF indecent in prefrail [1.46 (HR 1.46, 95% CI 1.09 to 1.95, P = 0.01] and frail (HR 3.33, 95% CI 1.86 to 5.70, P ≤ 0.001). In the sensitivity analysis, significant interaction between high BMI (≥25 kg/m2) and frailty was observed (P for interaction = 0.02). The association of frailty [multivariate‐adjusted HR: 2.88 (1.56 to 5.33), P ≤ 0.001)] and prefrailty [multivariate‐adjusted HR: 1.40 (1.08 to 1.91), P = 0.03)] with risk of HF indecent was more pronounced in those with high BMI. Conclusions Frailty is highly common in older age, and our results indicated the high risk of HF incident in frail and prefrail groups. While frailty is clinically recognized by weight loss phenotype, our finding showed that frailly and high BMI can coexist and worsen the risk of HF incidence. Further research is warranted to substantiate these results in large studies and clinical settings. |
| first_indexed | 2024-03-12T21:26:39Z |
| format | Article |
| id | doaj.art-7ca890f4ba1e44a6ab9ecfa28ce2e819 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-03-12T21:26:39Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
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| series | ESC Heart Failure |
| spelling | doaj.art-7ca890f4ba1e44a6ab9ecfa28ce2e8192023-07-28T06:30:48ZengWileyESC Heart Failure2055-58222023-08-011042354236110.1002/ehf2.14392Frailty alone and interactively with obesity predicts heart failure: Kuopio Ischaemic Heart Disease Risk Factor StudyBehnam Tajik0Ari Voutilainen1Rajiv Sankaranarayanan2Arja Lyytinen3Jussi Kauhanen4Gregory Y.H. Lip5Tomi‐Pekka Tuomainen6Masoud Isanejad7Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio FinlandInstitute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio FinlandInstitute of Life Course and Medical Sciences University of Liverpool Liverpool UKInstitute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio FinlandInstitute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio FinlandInstitute of Life Course and Medical Sciences University of Liverpool Liverpool UKInstitute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio FinlandInstitute of Life Course and Medical Sciences University of Liverpool Liverpool UKAbstract Aims We aim to evaluate the association of frailty and high body mass index with risk of incident heart failure. Methods and results From the Kuopio Ischaemic Heart Disease Risk Factor Study, 408 women and 369 men, aged 61–74 years were included in this study. Frailty was ascertained with the presence of 3–5 and prefrailty 1–2 of the following criteria: weight loss (highest 20% over 7 years), self‐reported tiredness, weakness (measured by handgrip strength), slow walking speed (walking pace), and low physical activity (lowest 20%). At the baseline, participants were allocated to frail (n = 36), prefrail (n = 340), and robust (n = 441). HF incidents were obtained by record linkages from the national hospitalization registry in Finland up to 31 December 2019. Multivariate Cox proportional hazards regression estimated the hazard ratio (HR) of incident events, adjusted for potential confounders. Two hundred one HF events were recorded (111 in women and 90 in men) during the 14.2 years follow‐up. After adjustment for the age and sex, the risk of HF events was higher among prefrail (HR 1.42, 95% CI 1.08 to 1.79, P = 0.02) and frail (HR 3.39, 95% CI 1.89 to 4.79, P ≤ 0.001) compared with the robust group. After adjusting for multiple confounders result remained significant for HF indecent in prefrail [1.46 (HR 1.46, 95% CI 1.09 to 1.95, P = 0.01] and frail (HR 3.33, 95% CI 1.86 to 5.70, P ≤ 0.001). In the sensitivity analysis, significant interaction between high BMI (≥25 kg/m2) and frailty was observed (P for interaction = 0.02). The association of frailty [multivariate‐adjusted HR: 2.88 (1.56 to 5.33), P ≤ 0.001)] and prefrailty [multivariate‐adjusted HR: 1.40 (1.08 to 1.91), P = 0.03)] with risk of HF indecent was more pronounced in those with high BMI. Conclusions Frailty is highly common in older age, and our results indicated the high risk of HF incident in frail and prefrail groups. While frailty is clinically recognized by weight loss phenotype, our finding showed that frailly and high BMI can coexist and worsen the risk of HF incidence. Further research is warranted to substantiate these results in large studies and clinical settings.https://doi.org/10.1002/ehf2.14392FrailtyHeart failureObesityBody mass indexPopulation study |
| spellingShingle | Behnam Tajik Ari Voutilainen Rajiv Sankaranarayanan Arja Lyytinen Jussi Kauhanen Gregory Y.H. Lip Tomi‐Pekka Tuomainen Masoud Isanejad Frailty alone and interactively with obesity predicts heart failure: Kuopio Ischaemic Heart Disease Risk Factor Study ESC Heart Failure Frailty Heart failure Obesity Body mass index Population study |
| title | Frailty alone and interactively with obesity predicts heart failure: Kuopio Ischaemic Heart Disease Risk Factor Study |
| title_full | Frailty alone and interactively with obesity predicts heart failure: Kuopio Ischaemic Heart Disease Risk Factor Study |
| title_fullStr | Frailty alone and interactively with obesity predicts heart failure: Kuopio Ischaemic Heart Disease Risk Factor Study |
| title_full_unstemmed | Frailty alone and interactively with obesity predicts heart failure: Kuopio Ischaemic Heart Disease Risk Factor Study |
| title_short | Frailty alone and interactively with obesity predicts heart failure: Kuopio Ischaemic Heart Disease Risk Factor Study |
| title_sort | frailty alone and interactively with obesity predicts heart failure kuopio ischaemic heart disease risk factor study |
| topic | Frailty Heart failure Obesity Body mass index Population study |
| url | https://doi.org/10.1002/ehf2.14392 |
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