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Unhealthy Behaviors Linked to Increased Risk of Heart Failure

by Amy

This week marks the conclusion of Heart Awareness Week, culminating in World Heart Day on Sunday, September 29.

Throughout September, Eikestadnuus has published articles highlighting heart failure (HF), thanks to contributions from the Heart and Stroke Foundation of South Africa (HSFSA). This week, the focus shifts to type 2 diabetes and other risk factors associated with HF.

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Heart failure is a common complication for individuals with diabetes, affecting between 9% and 22% of this population, particularly those over 60. The global prevalence of diabetes has surged by 30% in the last decade, further straining healthcare systems dealing with heart failure cases.

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Interestingly, HF can develop in diabetic patients even without hypertension, coronary artery disease, or valvular heart disease, making it a significant cardiovascular issue for this vulnerable group.

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According to the American Diabetes Association, a glycated hemoglobin A1C level above 7% is linked to an increased risk of developing advanced stages of heart failure. Each 1% rise in A1C raises the risk of HF by 30% in type 1 diabetes and by 8% in type 2 diabetes.

The connection between diabetes and heart failure is well-documented. Longitudinal studies indicate that men and women with diabetes or pre-diabetes face a two- to four-fold increased risk of developing heart failure compared to those without diabetes. A systematic review conducted by Ohkuma in 2019 analyzed 47 cohort studies and found that both type 1 and type 2 diabetes significantly increase the risk of heart failure in women more than in men.

Specifically, type 1 diabetes is associated with a 47% higher excess risk, while type 2 diabetes carries a 9% higher risk.

Effective management of diabetes may help reduce the incidence and progression of heart failure, positively impacting both quality of life and longevity.

Other notable risk factors for heart failure include coronary artery disease, high blood pressure, obesity, metabolic syndrome, hyperactive thyroid issues, aging, smoking, substance abuse (including alcohol), and certain types of radiation or chemotherapy.

Unhealthy behaviors such as consuming diets high in fat, cholesterol, and sodium; physical inactivity; smoking; vaping; and excessive alcohol use can elevate the risk of heart failure.

The American Heart Association reports that hypertension, obesity, diabetes, and smoking account for 52% of heart failure cases.

Controlling hypertension has been shown to reduce the risk of heart failure significantly—effective treatment can decrease incidents by up to 40%, as noted in a meta-analysis by Thomopoulos in 2016.

Both men and women are affected by heart failure; however, men typically develop it at a younger age while women often experience more severe symptoms. Research indicates that individuals of African descent have a 19% higher risk of developing heart failure compared to those of European descent. Additionally, Hispanic populations face multiple risk factors for heart failure along with healthcare disparities that may heighten their risk.

Shonisani Nephalama, head of the HSFSA’s nutrition science team, emphasized that healthy eating patterns—such as Mediterranean, whole-grain, plant-based diets, and dietary approaches to stop hypertension (DASH)—are inversely related to hypertension incidence and may offer protection against heart failure.

Nephalama also encouraged consumers to look for the HSFSA’s Heart Mark logo on food products as an indication that these items have been endorsed as healthy choices.

Throughout September, HSFSA healthcare practitioners have engaged communities across the country through various activities. They have provided health talks and health risk assessments (HRAs).

The HSFSA stresses the importance of understanding personal risks for cardiovascular diseases. Regular cardiovascular screenings are vital for monitoring key health indicators such as blood pressure, blood glucose levels, cholesterol levels, and body mass index (BMI). Keeping track of these metrics can significantly reduce the likelihood of experiencing heart attacks, strokes, or other cardiovascular conditions.

Juandre Watson, head of health promotion and health-risk assessment at HSFSA, urged all South Africans to be aware of their health numbers and adopt healthier lifestyles.

This year’s global theme for World Heart Day is “Use Heart For Action.”

This initiative is led by the World Heart Federation (WHF), which includes HSFSA as a proud member. The theme emphasizes not just awareness but also actionable efforts aimed at driving meaningful change in cardiovascular health.

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