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Risk factors

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Many different conditions may predispose to heart failure:

  • acute heart failure:
  • ischemic heart disease - acute coronary syndromes, mechanical complications of acute MI
  • valvular - stenosis, regurgitation, endocarditis
  • hypertension/arrhythmia
  • circulatory failure - septicaemia, thyrotoxicosis, pulmonary embolism
  • decompensation of pre-existing chronic HF - cerebrovascular insults, infections
  • chronic heart failure:
  • conditions that damage heart muscle or limit its ability to function normally:
    • coronary artery disease - commonest
    • hypertension - next most common cause
    • cardiomyopthy
    • drugs – beta blockers, calcium antagonists, antiarrhythmics, cytotoxic agents
    • toxins - alcohol, drugs, cocaine, mercury, cobalt, arsenic
    • endocrine - diabetes, hypo/hyperthyroidism, Cushing's syndrome
    • infiltrative conditions – sarcoidosis, amyloidosis
    • other conditions – Chagas’ disease, HIV infection
  • HF secondary to high cardiac output conditions
    • anaemia
    • thyrotoxicosis
    • septicaemia
    • liver failure
    • arteriovenous shunts (1)

Notes (2):

  • hypertension, diabetes, smoking history, and previous myocardial infarction conferred a greater relative risk of heart failure in younger than in older people
  • risk factors had greater discriminatory value in predicting new onset of heart failure in younger than in older people
  • a greater proportion of the overall population attributable risk was explained by diabetes, smoking history, and previous myocardial infarction in younger than in older people


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