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Targeting Other Modifiable Risk Factors for the Prevention of Heart Failure: Diabetes, Smoking, Obesity, and Inactivity

  • Heart Failure Prevention (S. Joseph, Section Editor)
  • Published:
Current Cardiovascular Risk Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Prevention and reduction of risk factors is imperative in the battle against the heart failure epidemic. In this report, we update prior reviews with a focus on the modifiable risk factors of diabetes, smoking, obesity, and inactivity with regard to epidemiology, pathophysiology, management, and therapeutic options.

Recent Findings

While the incidence of diabetes is rising, recent trials suggest options for diabetic patients to prevent cardiovascular morbidity, mortality, and heart failure, with several more trials underway. We highlight several novel agents including sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor antagonists. Tobacco smoking significantly increases the risk for heart failure, and recent data show early cessation may be beneficial. Education, support mechanisms, and weaning tools are useful, but some patients may benefit from behavioral counseling and even pharmacotherapy. Obesity is well recognized for its role in the development of heart failure and contributes to standard cardiovascular risk factors, left ventricular hypertrophy, sleep apnea, and metabolic syndrome. Lifestyle changes are vital to impacting this condition and thus rely heavily on patient motivation and compliance. Newer medications for assistance with weight loss have been approved, while bariatric surgery may be necessary for some. Specific effects of physical activity on heart failure prevention are not well delineated and may differ for patients with diabetes.

Summary

Extensive efforts in patient education on self-management of their health, prevention and control of risk factors will be the ultimate solution to decreasing the incidence of heart failure in the future.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Ambrosy AP, Fonarow GC, Butler J, Chioncel O, Greene SJ, Vaduganathan M, et al. The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J Am Coll Cardiol. 2014;63:1123–33.

    Article  PubMed  Google Scholar 

  2. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–e245.

    Article  PubMed  Google Scholar 

  3. Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123:933–44.

    Article  PubMed  Google Scholar 

  4. Heart Failure Society of America. Prevention of ventricular remodeling, cardiac dysfunction, and heart failure. J Card Fail. 2006;12:e12–5.

    Article  CAS  PubMed  Google Scholar 

  5. Arnold JM, Howlett JG, Dorian P, et al. Canadian Cardiovascular Society Consensus Conference recommendations on heart failure update 2007: prevention, management during intercurrent illness or acute decompensation, and use of biomarkers. Can J Cardiol. 2007;23:21–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. • Heart Failure Society of America. Executive summary: HFSA 2006 comprehensive heart failure practice guideline. J Card Fail. 2006;12:10–38. The 2006 Heart Failure Society of America comprehensive practice guideline addresses the full range of evaluation, care, and management of patients with HF.

    Article  Google Scholar 

  7. Hunt SA. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol. 2005;46:e1–82.

    Article  PubMed  Google Scholar 

  8. Swedberg K, Cleland J, Dargie H, Drexler H, Follath F, Komajda M, et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): the Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J. 2005;26:1115–40.

    Article  PubMed  Google Scholar 

  9. Schocken DD, Benjamin EJ, Fonarow GC, Krumholz HM, Levy D, Mensah GA, et al. Prevention of heart failure: a scientific statement from the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group. Circulation. 2008;117:2544–65. This statement from the American Heart Association addresses the identification, increasing incidence, and prevention of heart failure through aggressive implementation of evidencebased management of risk factors.

    Article  PubMed  Google Scholar 

  10. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writingommittee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005;112:e154–235.

    Article  PubMed  Google Scholar 

  11. Djousse L, Driver JA, Gaziano JM. Relation between modifiable lifestyle factors and lifetime risk of heart failure. JAMA. 2009;302:394–400.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Alba AC, Delgado DH. Optimal medical treatment of cardiovascular risk factors: can we prevent the development of heart failure? Expert Rev Cardiovasc Ther. 2009;7:147–57.

    Article  PubMed  Google Scholar 

  13. Danelich IM, Reed BN, Sueta CA. Stage A: can heart failure be prevented? Curr Cardiol Rev. 2015;11:4–9.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Dupree CS. Primary prevention of heart failure: what is the evidence? Curr Opin Cardiol. 2009;24:142–7.

    Article  PubMed  Google Scholar 

  15. Dupree CS. Primary prevention of heart failure: an update. Curr Opin Cardiol. 2010;25:478–83.

    Article  PubMed  Google Scholar 

  16. Grodin JL, Tang WH. Treatment strategies for the prevention of heart failure. Curr Heart Fail Rep. 2013;10:331–40.

    Article  CAS  PubMed  Google Scholar 

  17. Kohli P, Whelton SP, Hsu S, Yancy CW, Stone NJ, Chrispin J, et al. Clinician’s guide to the updated ABCs of cardiovascular disease prevention. J Am Heart Assoc. 2014;3:e001098.

    Article  PubMed  PubMed Central  Google Scholar 

  18. American Diabetes Association. Statistics About Diabetes 2017 [cited 2017 October 2]. Available from: http://www.diabetes.org/diabetes-basics/statistics/?loc=db-slabnav.

  19. Kannel WB, Hjortland M, Castelli WP. Role of diabetes in congestive heart failure: the Framingham study. Am J Cardiol. 1974;34:29–34.

    Article  CAS  PubMed  Google Scholar 

  20. Shindler DM, Kostis JB, Yusuf S, Quinones MA, Pitt B, Stewart D, et al. Diabetes mellitus, a predictor of morbidity and mortality in the Studies of Left Ventricular Dysfunction (SOLVD) Trials and Registry. Am J Cardiol. 1996;77:1017–20.

    Article  CAS  PubMed  Google Scholar 

  21. Ingelsson E, Sundstrom J, Arnlov J, Zethelius B, Lind L. Insulin resistance and risk of congestive heart failure. JAMA. 2005;294:334–41.

    Article  CAS  PubMed  Google Scholar 

  22. Nichols GA, Hillier TA, Erbey JR, Brown JB. Congestive heart failure in type 2 diabetes: prevalence, incidence, and risk factors. Diabetes Care. 2001;24:1614–9.

    Article  CAS  PubMed  Google Scholar 

  23. Giles TD, Sander GE. Diabetes mellitus and heart failure: basic mechanisms, clinical features, and therapeutic considerations. Cardiol Clin. 2004;22:553–68.

    Article  PubMed  Google Scholar 

  24. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339:229–34.

    Article  CAS  PubMed  Google Scholar 

  25. Devereux RB, Roman MJ, Paranicas M, O'Grady MJ, Lee ET, Welty TK, et al. Impact of diabetes on cardiac structure and function: the strong heart study. Circulation. 2000;101:2271–6.

    Article  CAS  PubMed  Google Scholar 

  26. Struthers AD, Morris AD. Screening for and treating left-ventricular abnormalities in diabetes mellitus: a new way of reducing cardiac deaths. Lancet. 2002;359:1430–2.

    Article  PubMed  Google Scholar 

  27. Kamalesh M. Heart failure in diabetes and related conditions. J Card Fail. 2007;13:861–73.

    Article  PubMed  Google Scholar 

  28. Bell DS. Hypertension in the person with diabetes. Am J Med Sci. 1989;297:228–32.

    Article  CAS  PubMed  Google Scholar 

  29. Saunders J, Mathewkutty S, Drazner MH, McGuire DK. Cardiomyopathy in type 2 diabetes: update on pathophysiological mechanisms. Herz. 2008;33:184–90.

    Article  PubMed  Google Scholar 

  30. Regan TJ, Lyons MM, Ahmed SS, Levinson GE, Oldewurtel HA, Ahmad MR, et al. Evidence for cardiomyopathy in familial diabetes mellitus. J Clin Invest. 1977;60:884–99.

    Article  CAS  PubMed  Google Scholar 

  31. Adameova A, Dhalla NS. Role of microangiopathy in diabetic cardiomyopathy. Heart Fail Rev. 2014;19:25–33.

    Article  PubMed  Google Scholar 

  32. Huynh K, Bernardo BC, McMullen JR, Ritchie RH. Diabetic cardiomyopathy: mechanisms and new treatment strategies targeting antioxidant signaling pathways. Pharmacol Ther. 2014;142:375–415.

    Article  CAS  PubMed  Google Scholar 

  33. Riehle C, Abel ED. Insulin signaling and heart failure. Circ Res. 2016;118:1151–69.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Srikanthan P, Hsueh W. Preventing heart failure in patients with diabetes. Med Clin North Am. 2004;88:1237–56.

    Article  CAS  PubMed  Google Scholar 

  35. Iribarren C, Karter AJ, Go AS, Ferrara A, Liu JY, Sidney S, et al. Glycemic control and heart failure among adult patients with diabetes. Circulation. 2001;103:2668–73.

    Article  CAS  PubMed  Google Scholar 

  36. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Patel A, MacMahon S, Chalmers J, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560–72.

    Article  CAS  PubMed  Google Scholar 

  38. Zhong J, Goud A, Rajagopalan S. Glycemia lowering and risk for heart failure: recent evidence from studies of dipeptidyl peptidase inhibition. Circ Heart Fail. 2015;8:819–25.

    Article  PubMed  Google Scholar 

  39. Gerstein HC, Miller ME, Byington RP, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358:2545–59.

    Article  CAS  PubMed  Google Scholar 

  40. Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven PD, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360:129–39.

    Article  CAS  PubMed  Google Scholar 

  41. Kirpichnikov D, McFarlane SI, Sowers JR. Metformin: an update. Ann Intern Med. 2002;137:25–33.

    Article  CAS  PubMed  Google Scholar 

  42. Aguilar D, Chan W, Bozkurt B, Ramasubbu K, Deswal A. Metformin use and mortality in ambulatory patients with diabetes and heart failure. Circ Heart Fail. 2011;4:53–8.

    Article  CAS  PubMed  Google Scholar 

  43. MacDonald MR, Eurich DT, Majumdar SR, et al. Treatment of type 2 diabetes and outcomes in patients with heart failure: a nested case-control study from the U.K. General Practice Research Database. Diabetes Care. 2010;33:1213–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Shah DD, Fonarow GC, Horwich TB. Metformin therapy and outcomes in patients with advanced systolic heart failure and diabetes. J Card Fail. 2010;16:200–6.

    Article  CAS  PubMed  Google Scholar 

  45. Romero SP, Andrey JL, Garcia-Egido A, Escobar MA, Perez V, Corzo R, et al. Metformin therapy and prognosis of patients with heart failure and new-onset diabetes mellitus. A propensity-matched study in the community. Int J Cardiol. 2013;166:404–12.

    Article  PubMed  Google Scholar 

  46. Roussel R, Travert F, Pasquet B, Wilson PW, Smith SC Jr, Goto S, et al. Metformin use and mortality among patients with diabetes and atherothrombosis. Arch Intern Med. 2010;170:1892–9.

    Article  CAS  PubMed  Google Scholar 

  47. Inzucchi SE, Masoudi FA, Wang Y, Kosiborod M, Foody JM, Setaro JF, et al. Insulin-sensitizing antihyperglycemic drugs and mortality after acute myocardial infarction: insights from the National Heart Care Project. Diabetes Care. 2005;28:1680–9.

    Article  CAS  PubMed  Google Scholar 

  48. Gundewar S, Calvert JW, Jha S, Toedt-Pingel I, Yong Ji S, Nunez D, et al. Activation of AMP-activated protein kinase by metformin improves left ventricular function and survival in heart failure. Circ Res. 2009;104:403–11.

    Article  CAS  PubMed  Google Scholar 

  49. Eurich DT, Weir DL, Majumdar SR, Tsuyuki RT, Johnson JA, Tjosvold L, et al. Comparative safety and effectiveness of metformin in patients with diabetes mellitus and heart failure: systematic review of observational studies involving 34,000 patients. Circ Heart Fail. 2013;6:395–402.

    Article  CAS  PubMed  Google Scholar 

  50. Tzoulaki I, Molokhia M, Curcin V, Little MP, Millett CJ, Ng A, et al. Risk of cardiovascular disease and all cause mortality among patients with type 2 diabetes prescribed oral antidiabetes drugs: retrospective cohort study using UK general practice research database. BMJ. 2009;339:b4731.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Varas-Lorenzo C, Margulis AV, Pladevall M, Riera-Guardia N, Calingaert B, Hazell L, et al. The risk of heart failure associated with the use of noninsulin blood glucose-lowering drugs: systematic review and meta-analysis of published observational studies. BMC Cardiovasc Disord. 2014;14:129.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Bosch J, Lonn E, Pogue J, Arnold JM, Dagenais GR, Yusuf S. Long-term effects of ramipril on cardiovascular events and on diabetes: results of the HOPE study extension. Circulation. 2005;112:1339–46.

    Article  PubMed  Google Scholar 

  53. Mann JF, Gerstein HC, Yi QL, Franke J, Lonn EM, Hoogwerf BJ, et al. Progression of renal insufficiency in type 2 diabetes with and without microalbuminuria: results of the Heart Outcomes and Prevention Evaluation (HOPE) randomized study. Am J Kidney Dis. 2003;42:936–42.

    Article  PubMed  Google Scholar 

  54. Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001;345:851–60.

    Article  CAS  PubMed  Google Scholar 

  55. Brenner BM, Cooper ME, de Zeeuw D, Keane WF, Mitch WE, Parving HH, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001;345:861–9.

    Article  CAS  PubMed  Google Scholar 

  56. Catala-Lopez F, Macias Saint-Gerons D, Gonzalez-Bermejo D, et al. Cardiovascular and renal outcomes of renin-angiotensin system blockade in adult patients with diabetes mellitus: a systematic review with network meta-analyses. PLoS Med. 2016;13:e1001971.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldini AL. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011;34:1934–42.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Nundy S, Dick JJ, Chou CH, Nocon RS, Chin MH, Peek ME. Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants. Health Aff (Millwood). 2014;33:265–72.

    Article  Google Scholar 

  59. Quinn CC, Clough SS, Minor JM, Lender D, Okafor MC, Gruber-Baldini A. WellDoc mobile diabetes management randomized controlled trial: change in clinical and behavioral outcomes and patient and physician satisfaction. Diabetes Technol Ther. 2008;10:160–8.

    Article  PubMed  Google Scholar 

  60. American Diabetes A. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33:S11–61.

    Article  Google Scholar 

  61. Center for Drug Evaluation and Research. Guidance for industry: diabetes mellitus—evaluating cardiovascular risk in new antidiabetic therapies to treat type 2 diabetes 2008 [cited 2017 October 2]. Available from: https://www.fda.gov/downloads/Drugs/.../Guidances/ucm071627.pdf.

  62. Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373:2117–28.

    Article  CAS  PubMed  Google Scholar 

  63. Grempler R, Thomas L, Eckhardt M, Himmelsbach F, Sauer A, Sharp DE, et al. Empagliflozin, a novel selective sodium glucose cotransporter-2 (SGLT-2) inhibitor: characterisation and comparison with other SGLT-2 inhibitors. Diabetes Obes Metab. 2012;14:83–90.

    Article  CAS  PubMed  Google Scholar 

  64. Barnett AH, Mithal A, Manassie J, Jones R, Rattunde H, Woerle HJ, et al. Efficacy and safety of empagliflozin added to existing antidiabetes treatment in patients with type 2 diabetes and chronic kidney disease: a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2014;2:369–84.

    Article  CAS  PubMed  Google Scholar 

  65. Packer M, Anker SD, Butler J, Filippatos G, Zannad F. Effects of sodium-glucose cotransporter 2 inhibitors for the treatment of patients with heart failure: proposal of a novel mechanism of action. JAMA Cardiol. 2017;2:1025–9.

    Article  PubMed  Google Scholar 

  66. Kosiborod M, Cavender MA, Fu AZ, Wilding JP, Khunti K, Holl RW, et al. Lower risk of heart failure and death in patients initiated on sodium-glucose cotransporter-2 inhibitors versus other glucose-lowering drugs: the CVD-REAL study (comparative effectiveness of cardiovascular outcomes in new users of sodium-glucose cotransporter-2 inhibitors). Circulation. 2017;136:249–59.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017;377:644–57.

    Article  CAS  PubMed  Google Scholar 

  68. US Department of Health and Human Services. FDA Drug Safety Communication: FDA confirms increased risk of leg and foot amputations with the diabetes medicine canagliflozin (Invokana, Invokamet, Invokamet XR) 2017 [cited 2017 October 2]. Available from: https://www.fda.gov/Drugs/DrugSafety/ucm557507.htm.

  69. Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375:1834–44.

    Article  CAS  PubMed  Google Scholar 

  70. Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375:311–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Nauck M. Incretin therapies: highlighting common features and differences in the modes of action of glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors. Diabetes Obes Metab. 2016;18:203–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Kaul S. Mitigating cardiovascular risk in type 2 diabetes with antidiabetes drugs: a review of principal cardiovascular outcome results of EMPA-REG OUTCOME, LEADER, and SUSTAIN-6 trials. Diabetes Care. 2017;40:821–31.

    Article  PubMed  Google Scholar 

  73. Centers for Disease Control and Prevention. Smoking & Tobacco Use - Data and Statistics 2017 [cited 2017 October 2]. Available from: https://www.cdc.gov/tobacco/data_statistics/.

  74. Eliasson B. Cigarette smoking and diabetes. Prog Cardiovasc Dis. 2003;45:405–13.

    Article  CAS  PubMed  Google Scholar 

  75. Horwich TB, Fonarow GC. Prevention of heart failure. Curr Cardiol Rep. 2002;4:194–9.

    Article  PubMed  Google Scholar 

  76. Hoffman RM, Psaty BM, Kronmal RA. Modifiable risk factors for incident heart failure in the coronary artery surgery study. Arch Intern Med. 1994;154:417–23.

    Article  CAS  PubMed  Google Scholar 

  77. Ahmed AA, Patel K, Nyaku MA, Kheirbek RE, Bittner V, Fonarow GC, et al. Risk of heart failure and death after prolonged smoking cessation: role of amount and duration of prior smoking. Circ Heart Fail. 2015;8:694–701.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Hawkins NM, Virani S, Ceconi C. Heart failure and chronic obstructive pulmonary disease: the challenges facing physicians and health services. Eur Heart J. 2013;34:2795–803.

    Article  PubMed  Google Scholar 

  79. Plesner LL, Dalsgaard M, Schou M, et al. The prognostic significance of lung function in stable heart failure outpatients. Clin Cardiol. 2017;40:1145-1151.

  80. Centers for Disease Control and Prevention. Quitting smoking among adults—United States, 2001-2010. MMWR Morb Mortal Wkly Rep. 2011;60:1513–9.

    Google Scholar 

  81. Cahill K, Stead LF, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev. 2012 Apr 18;(4):CD006103.

  82. Jorenby DE, Hays JT, Rigotti NA, Azoulay S, Watsky EJ, Williams KE, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA. 2006;296:56–63.

    Article  CAS  PubMed  Google Scholar 

  83. Kenchaiah S, Evans JC, Levy D, Wilson PWF, Benjamin EJ, Larson MG, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347:305–13.

    Article  PubMed  Google Scholar 

  84. Centers for Disease Control and Prevention. Adult obesity facts 2017 [cited 2017 October 2]. Available from: https://www.cdc.gov/obesity/data/adult.html.

  85. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society. J Am Coll Cardiol. 2014;63:2985–3023.

    Article  PubMed  Google Scholar 

  86. Bahrami H, Bluemke DA, Kronmal R, Bertoni AG, Lloyd-Jones DM, Shahar E, et al. Novel metabolic risk factors for incident heart failure and their relationship with obesity: the MESA (Multi-Ethnic Study of Atherosclerosis) study. J Am Coll Cardiol. 2008;51:1775–83.

    Article  CAS  PubMed  Google Scholar 

  87. Massie BM. Obesity and heart failure--risk factor or mechanism? N Engl J Med. 2002;347:358–9.

    Article  PubMed  Google Scholar 

  88. Rider OJ, Cox P, Tyler D, Clarke K, Neubauer S. Myocardial substrate metabolism in obesity. Int J Obes. 2013;37:972–9.

    Article  CAS  Google Scholar 

  89. Salehi-Abargouei A, Maghsoudi Z, Shirani F, Azadbakht L. Effects of Dietary Approaches to Stop Hypertension (DASH)-style diet on fatal or nonfatal cardiovascular diseases--incidence: a systematic review and meta-analysis on observational prospective studies. Nutrition. 2013;29:611–8.

    Article  PubMed  Google Scholar 

  90. Das UN. Nutritional factors in the prevention and management of coronary artery disease and heart failure. Nutrition. 2015;31:283–91.

    Article  CAS  PubMed  Google Scholar 

  91. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002;287:356–9.

    Article  PubMed  Google Scholar 

  92. Laaksonen DE, Lakka HM, Niskanen LK, Kaplan GA, Salonen JT, Lakka TA. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol. 2002;156:1070–7.

    Article  PubMed  Google Scholar 

  93. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society. Circulation. 2014;129:S102–38.

    Article  PubMed  Google Scholar 

  94. Jindal A, Whaley-Connell A, Brietzke S, Sowers JR. Therapy of obese patients with cardiovascular disease. Curr Opin Pharmacol. 2013;13:200–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Chudyk A, Petrella RJ. Effects of exercise on cardiovascular risk factors in type 2 diabetes: a meta-analysis. Diabetes Care. 2011;34:1228–37.

    Article  PubMed  PubMed Central  Google Scholar 

  96. The Look Ahead Research Group. Long term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes: four year results of the look AHEAD trial. Arch Intern Med. 2010;170:1566–75.

    PubMed Central  Google Scholar 

  97. Gæde P, Vedel P, Parving H-H, Pedersen O. Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: the steno type 2 randomised study. Lancet. 1999;353:617–22.

    Article  PubMed  Google Scholar 

  98. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.

    Article  PubMed Central  Google Scholar 

  99. Young DR, Reynolds K, Sidell M, Brar S, Ghai NR, Sternfeld B, et al. Effects of physical activity and sedentary time on the risk of heart failure. Circ Heart Fail. 2014;7:21–7.

    Article  PubMed  Google Scholar 

  100. Kenchaiah S, Narula J, Vasan RS. Risk factors for heart failure. Med Clin North Am. 2004;88:1145–72.

    Article  PubMed  Google Scholar 

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  1. Center for Advanced Heart and Lung Disease, Baylor University Medical Center, 3410 Worth Street, Suite 545, Dallas, TX, 75246, USA

    Timothy A. Gong & Shelley A. Hall

  2. Annette C. and Harold C. Simmons Transplant Institute, Baylor Scott & White Research Institute, Dallas, TX, USA

    Timothy A. Gong & Shelley A. Hall

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This article is part of the Topical Collection on Heart Failure Prevention

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Gong, T.A., Hall, S.A. Targeting Other Modifiable Risk Factors for the Prevention of Heart Failure: Diabetes, Smoking, Obesity, and Inactivity. Curr Cardiovasc Risk Rep 12, 12 (2018). https://doi.org/10.1007/s12170-018-0574-9

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