Hypertension and obesity are the strongest risk factors for new-onset heart failure (HF) in both men and women, but women are still at greater risk than men, a new analysis of the U.K. Biobank shows. Hailun Quin, MD, of the University of Groningen, the Netherlands, and colleagues, reported these results in a manuscript published online in JACC: Heart Failure. Risk factors for HF in men and women have been thoroughly examined through population-based studies over the years. However, sex-specific factors and mechanisms for these risk factors have yet to be determined. Obesity and hypertension are the two most reported risk factors for HF. The investigators in this study examined the clinical impacts and proteomic risk profiles of new-onset HF in both men and women, considering eight common HF risk factors: obesity, smoking, socioeconomic status, atrial fibrillation, type 2 diabetes, hypertension, hyperlipidemia and history of myocardial infarction (MI). A total of 2,923 unique proteins from Olink were analyzed in the proteomics data, and these were available from 22,695 men and 27,421 women. Biological pathways were identified in men and women with new-onset HF using pathway over-representation analyses. Weighted scores were extracted via principal component analyses, and the weighted scores were used to investigate the association between HF and the risk factors. The rate of HF was 3.60 per 1,000 person-years in men and 1.72 per 1,000 person-years in women during a median follow-up of 12 years (p<0.001). Future HF was most heavily predicted by prior MI (hazard ratio [HR]=2.61, 95% confidence interval [CI]=2.46-2.77) in men and atrial fibrillation (HR=4.10, 95% CI=3.58-4.71) in women. Women were at greater risk of new-onset HF when they had a risk factor, compared with men. The population-attributable risk in both men and women was highest for hypertension (men=25%, women=29%) and obesity (men=16%, women=21%). Inflammatory pathways, particularly neutrophil degranulation, were activated in both men and women who developed HF. The association between hypertension and new-onset HF was moderately impacted by the inflammatory pathways (men=22%, women=24%), but even more so by obesity (men=33%, women=47%). Overall, new-onset HF was most strongly predicted by hypertension and obesity in both men and women, and inflammatory pathways could be involved in the development of new-onset HF. Source: Qin H, Tromp J, M. ter Maaten J, et al. Cinical and proteomic risk profiles of new-onset heart failure in men and women. JACC: Heart Fail. 2024 Dec 20 (Article in press) Image Credit: eddows-stock.adobe.com