Diabetes Is an Independent Risk Factor for Heart Failure

human heart
A heart attack (myocardial infarction) is usually caused by a blood clot, which stops the blood flowing to a part of your heart muscle.
Researchers assessed the long-term effect of diabetes on risk for the development of heart failure.

Diabetes is an independent risk factor for developing heart failure (HF), according to study results published in Mayo Clinic Proceedings.

The researchers performed a cross-sectional study of patients aged ≥45 years who were residents of Olmsted County, Minnesota, recruited to the Rochester Epidemiology Project from June 1, 1997 through September 30, 2000 (N=2042). Patients underwent assessment of systolic and diastolic function and cardiac structure with echocardiography.

All patients with diabetes were matched 1:2 for age, sex, hypertension, diastolic dysfunction, and coronary artery disease with a control group without diabetes. The researchers compared baseline characteristics, laboratory findings, echocardiography findings, and rates of mortality due to various cardiovascular conditions between groups.

Overall, the researchers identified 116 patients with diabetes and matched them to 232 control patients. Compared with controls, patients with diabetes had higher body mass index, median insulin levels, and serum glucose levels. The ratio of passive transmitral of left ventricular inflow velocity to tissue Doppler imaging velocity of the medial mitral annulus during passive filling (E/e΄ ratio) was also higher in patients with diabetes compared with controls (9.7 vs 8.5; P <.001).

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During a mean 10.8 years of follow-up, the researchers observed that patients with diabetes had a higher incidence of HF (hazard ratio, 2.1; 95% CI, 1.2-3.6; P =.01) compared with controls. In addition, patients with diabetes had a 10-year Kaplan-Meier rate for HF of 21% (22 of 116) compared with 12% (24 or 232) of controls.

After analyzing a subgroup of patients without diastolic dysfunction, the researchers found that patients with diabetes still had an increased risk for HF (hazard ratio, 2.5; 95% CI, 1.0-6.3; P =.04).

The study had several limitations, including its predominantly rural white population, which makes it difficult to apply these results to the United States population as a whole. In addition, the researchers noted that they used a relatively small cohort with a limited amount of follow-up.

“Future research should be focused on whether aggressive management of risk factors such as [body mass index] and glucose and cholesterol levels will decrease the development of HF in patients with [diabetes],” the researchers wrote.


Klajda M, Scott CG, Rodeheffer RJ, Chen HH. Diabetes mellitus is an independent predictor for the development of heart failure: a population study. Mayo Clin Proc. 2020;95(1):124-133.

This article originally appeared on Endocrinology Advisor