The incidence rate of heart failure was 2- to 3-fold higher among American Indian populations than rates observed in studies focused on other population groups, such as African American, Hispanic or white adults, in a new study published today in the Journal of the American Heart Association,

The results were calculated using a new proposed risk prediction scale for heart failure specifically for American Indian adults. The analysis also found that smoking, type 2 diabetes status, kidney damage, previous heart attack and high blood pressure are major modifiable determinants of developing heart failure over 5 to 10 years among American Indian adults.

“Implementation of our proposed risk prediction scale in clinical practice can contribute to optimized risk assessment and to the development of preventive strategies to reduce heart failure events and deaths in American Indian communities and populations with a high burden of type 2 diabetes, which have been underrepresented. in previous studies,” said lead study author Irene Martinez-Morata MD, Ph.D., and a researcher at Columbia University’s Mailman School of Public Health in New York City.

Heart failure is a leading cause of death among people with type 2 diabetes, and occurs at a higher rate in American Indian populations than in Black, Hispanic and white populations in the US Existing heart failure risk prediction scales may not appropriately estimate the risk of heart failure failure among American Indian communities and other populations affected by a high rate of type 2 diabetes, Martinez-Morata noted.

In this study, researchers developed a scale to predict heart failure risk specifically in American Indian people, based on data from about 3,000 participants in the Strong Heart Study, an ongoing study that is the largest to examine heart disease in American Indian adults. The inexpensive risk prediction equation, which uses readily available tools focused on type 2 diabetes management and kidney damage.

The analysis found:

• The overall incidence rate of heart failure was 2- to 3-fold higher in participants of the Strong Heart Study than rates observed in other population-based studies such as those including African American, Hispanic or white adults;
• Sustained levels of high blood sugar were associated with a 23% increased risk on top of type 2 diabetes, indicating that blood sugar control is important to reduce the risk of heart failure even among patients with established diabetes;
• Smoking was associated with double the risk of developing heart failure over both 5 and 10 years;
• Elevated albumin in the urine, which can indicate kidney damage related to type-2 diabetes and hypertension, was linked with an 8-times higher risk of developing heart failure over 5 years;
• Having a previous heart attack was associated with a nearly 7 times higher risk of developing heart failure within 5 years;
• Older age was associated with roughly 70% to 80% higher risk of developing heart failure over 5 or 10 years, respectively;
• Type 2 diabetes was associated with a 74% increased risk of developing heart failure within 10 years; and
• High blood pressure increased the risk of developing heart failure at 10 years by 43%.