Association Between Cardiometabolic Comorbidity Burden and Outcomes in Heart Failure
Background Cardiometabolic comorbidities such as obesity, diabetes, and hypertension are highly prevalent in heart failure (HF). We aimed to examine the association between severity of cardiometabolic comorbidities and hospitalization in patients with HF. Methods In a retrospective electronic health...
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Wiley
2025-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.036985 |
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| author | Carine E. Hamo Xiyue Li Chiadi E. Ndumele Amrita Mukhopadhyay Samrachana Adhikari Saul Blecker |
| author_facet | Carine E. Hamo Xiyue Li Chiadi E. Ndumele Amrita Mukhopadhyay Samrachana Adhikari Saul Blecker |
| author_sort | Carine E. Hamo |
| collection | DOAJ |
| description | Background Cardiometabolic comorbidities such as obesity, diabetes, and hypertension are highly prevalent in heart failure (HF). We aimed to examine the association between severity of cardiometabolic comorbidities and hospitalization in patients with HF. Methods In a retrospective electronic health record‐based cohort of adults ≥$$ \ge $$18 with HF, we categorized individuals based on the number of severe cardiometabolic comorbidities, including hypertension, diabetes, and obesity. Severely uncontrolled comorbidities were defined as systolic blood pressure ≥160 mm Hg, hemoglobin A1c ≥8%, and body mass index ≥35 kg/m2. Cox regression models were used to assess the association between cardiometabolic comorbidity burden and time to all‐cause and HF hospitalization at 1 year, adjusting for age, sex, race or ethnicity, and insurance status, smoking, prior hospitalization, and Elixhauser comorbidity index. Stratified analyses were conducted for HF with preserved and reduced ejection fraction. Results A total of 26 800 individuals with HF (mean age 75±$$ \pm $$13.7, 46% women, 69% White) experienced 4284 (16%) hospitalizations over a 1‐year period. Compared with individuals with absent comorbidities, those with 1 or 2 to 3 severely uncontrolled comorbidities had a significantly higher risk of all‐cause hospitalization (hazard ratio [HR], 1.23 [95% CI, 1.09–1.39] and HR, 1.57 [95% CI, 1.35–1.83], respectively). We found similar associations for HF hospitalization. These associations were similar among individuals with HF with preserved ejection fraction compared with HF with reduced ejection fraction. Conclusions Greater cardiometabolic comorbidity burden was associated with increased risk of all‐cause hospitalization in HF. This reinforces the role for targeting severely uncontrolled cardiometabolic comorbidities to reduce morbidity in HF. |
| format | Article |
| id | doaj-art-934d97ee1a6f4023a1880da2c28670d3 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-934d97ee1a6f4023a1880da2c28670d32025-02-04T11:00:01ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-02-0114310.1161/JAHA.124.036985Association Between Cardiometabolic Comorbidity Burden and Outcomes in Heart FailureCarine E. Hamo0Xiyue Li1Chiadi E. Ndumele2Amrita Mukhopadhyay3Samrachana Adhikari4Saul Blecker5Leon H. Charney Division of Cardiology, Department of Medicine New York University School of Medicine New York NYDepartment of Population Health New York University Grossman School of Medicine New York NYDivision of Cardiology Johns Hopkins University Baltimore MDLeon H. Charney Division of Cardiology, Department of Medicine New York University School of Medicine New York NYDepartment of Population Health New York University Grossman School of Medicine New York NYDepartment of Population Health New York University Grossman School of Medicine New York NYBackground Cardiometabolic comorbidities such as obesity, diabetes, and hypertension are highly prevalent in heart failure (HF). We aimed to examine the association between severity of cardiometabolic comorbidities and hospitalization in patients with HF. Methods In a retrospective electronic health record‐based cohort of adults ≥$$ \ge $$18 with HF, we categorized individuals based on the number of severe cardiometabolic comorbidities, including hypertension, diabetes, and obesity. Severely uncontrolled comorbidities were defined as systolic blood pressure ≥160 mm Hg, hemoglobin A1c ≥8%, and body mass index ≥35 kg/m2. Cox regression models were used to assess the association between cardiometabolic comorbidity burden and time to all‐cause and HF hospitalization at 1 year, adjusting for age, sex, race or ethnicity, and insurance status, smoking, prior hospitalization, and Elixhauser comorbidity index. Stratified analyses were conducted for HF with preserved and reduced ejection fraction. Results A total of 26 800 individuals with HF (mean age 75±$$ \pm $$13.7, 46% women, 69% White) experienced 4284 (16%) hospitalizations over a 1‐year period. Compared with individuals with absent comorbidities, those with 1 or 2 to 3 severely uncontrolled comorbidities had a significantly higher risk of all‐cause hospitalization (hazard ratio [HR], 1.23 [95% CI, 1.09–1.39] and HR, 1.57 [95% CI, 1.35–1.83], respectively). We found similar associations for HF hospitalization. These associations were similar among individuals with HF with preserved ejection fraction compared with HF with reduced ejection fraction. Conclusions Greater cardiometabolic comorbidity burden was associated with increased risk of all‐cause hospitalization in HF. This reinforces the role for targeting severely uncontrolled cardiometabolic comorbidities to reduce morbidity in HF.https://www.ahajournals.org/doi/10.1161/JAHA.124.036985cardiometabolicdiabetesheart failurehospitalizationhypertensionobesity |
| spellingShingle | Carine E. Hamo Xiyue Li Chiadi E. Ndumele Amrita Mukhopadhyay Samrachana Adhikari Saul Blecker Association Between Cardiometabolic Comorbidity Burden and Outcomes in Heart Failure Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiometabolic diabetes heart failure hospitalization hypertension obesity |
| title | Association Between Cardiometabolic Comorbidity Burden and Outcomes in Heart Failure |
| title_full | Association Between Cardiometabolic Comorbidity Burden and Outcomes in Heart Failure |
| title_fullStr | Association Between Cardiometabolic Comorbidity Burden and Outcomes in Heart Failure |
| title_full_unstemmed | Association Between Cardiometabolic Comorbidity Burden and Outcomes in Heart Failure |
| title_short | Association Between Cardiometabolic Comorbidity Burden and Outcomes in Heart Failure |
| title_sort | association between cardiometabolic comorbidity burden and outcomes in heart failure |
| topic | cardiometabolic diabetes heart failure hospitalization hypertension obesity |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.036985 |
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