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QUARTERLY FOCUS ISSUE: HEART FAILURE: STATE-OF-THE-ART PAPER

Glucose, Obesity, Metabolic Syndrome, and Diabetes

Relevance to Incidence of Heart Failure

Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, Los Angeles, California

Manuscript received April 7, 2009; revised manuscript received June 22, 2009, accepted July 8, 2009.

^_* Reprint requests and correspondence: Dr. Gregg C. Fonarow, Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center, 10833 LeConte Avenue, Room 47-123 CHS, Los Angeles, California 90095-1679 (Email: gfonarow{at}mednet.ucla.edu).

Heart failure (HF) is common, results in poor clinical outcomes, and is associated with large health care costs. The incidence of HF continues to rise, with approximately 670,000 new cases per year and a 20% lifetime risk of HF for persons 40 years and older in the U.S. Risk factors for HF have been identified, and thus preventative strategies should have a positive effect on disease burden, morbidity, and mortality. Although coronary artery disease and hypertension have traditionally been considered among the most important modifiable risk factors for the development of HF, recent studies have highlighted the importance of increasingly prevalent metabolic risk factors: glucose, diabetes, obesity, and the metabolic syndrome. This report will present evidence for the link between glucose, diabetes, obesity, metabolic syndrome, and incident HF. Furthermore, we will discuss how risk factor modification and other preventive therapies may help curb the rising incidence of HF.

Key Words: glucose • obesity • heart failure • metabolic syndrome • diabetes

Abbreviations and Acronyms   BMI = body mass index   CI = confidence interval   HbA1c = glycosylated hemoglobin   HF = heart failure   TZD = thiazolidinedione

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